| NPI | 1659545978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEHJAN S MARTIN CEO 239-848-6515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2008-04-17 |
| Last Update Date | 2008-07-16 |