| NPI | 1134741218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAIR LYNNE DEICKE CEO/Owner 941-870-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2020-05-12 |
| Last Update Date | 2020-05-12 |