| NPI | 1538407291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH MIRABELLA Member/Owner 239-331-4774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: FL 2011AD0820-01) |
| Enumeration Date | 2013-01-30 |
| Last Update Date | 2013-01-30 |