| NPI | 1255720389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE ROSE SIMMONS Owner/President 239-272-6214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH12440) |
| Enumeration Date | 2015-01-13 |
| Last Update Date | 2015-01-13 |