| NPI | 1114769031 |
|---|---|
| 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) |
| Additional Taxonomies | 101Y00000X Counselor |
| 103K00000X Behavior Analyst | |
| 103TC0700X Psychologist, Clinical | |
| 104100000X Social Worker | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2024-06-11 |
| Last Update Date | 2024-06-13 |