| NPI | 1275889255 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL L GINGRAS Vice President 239-598-3131 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2012-11-26 |