| NPI | 1003568015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH NOEMI DOSORETZ CEO 239-223-2751 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-01-20 |
| Last Update Date | 2025-06-05 |