| NPI | 1356965974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE LEE FOLSOM-MARTIN President 239-260-1978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2020-05-29 |
| Last Update Date | 2020-05-29 |