| NPI | 1487322293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESUS RAMOS Mgr 239-250-9411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 251B00000X Case Management |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2021-09-06 |
| Last Update Date | 2026-06-03 |