| NPI | 1588102347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN S MANGAN Owner 239-777-2454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH13836) |
| Enumeration Date | 2017-02-01 |
| Last Update Date | 2017-02-01 |