| NPI | 1326751926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANA SMITH Administrator 239-258-1477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| 103T00000X Psychologist | |
| 103TC1900X Psychologist, Counseling | |
| 1041C0700X Social Worker, Clinical | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2022-12-29 |
| Last Update Date | 2022-12-29 |