| NPI | 1194472498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID BASSANO Managing Partner/COO 239-290-7297 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2022-03-07 |
| Last Update Date | 2023-12-12 |