| NPI | 1215522263 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA THOMAS Owner 239-908-9958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QI0500X Clinic/Center Infusion Therapy |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2021-03-02 |
| Last Update Date | 2021-03-02 |