NPI | 1639461312 |
---|---|
Entity Type | Organization |
Authorized Contact | GERARD V SPRAGUE Clinical Supervisor 239-332-8009 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL 1063528560) |
Enumeration Date | 2011-05-12 |
Last Update Date | 2011-05-12 |