| NPI | 1063878361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOE L HUDSON Director Of Operation 239-227-2839 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL 2011AD873101) |
| Enumeration Date | 2016-01-04 |
| Last Update Date | 2017-03-01 |