| 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 |