| NPI | 1639614217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA J BUNCK Licensed Clinical Social Worker 239-910-0955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL SW5026) |
| Enumeration Date | 2017-01-05 |
| Last Update Date | 2017-01-05 |