| NPI | 1629670013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER CRAIG CEO 239-216-0431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2020-11-11 |
| Last Update Date | 2020-12-21 |