| NPI | 1104559848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASMINE CURTIS Credentialing Director 239-236-8784 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-07-08 |
| Last Update Date | 2022-07-08 |