| NPI | 1720433022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD HANDY COO 239-935-5599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 2084P0802X Psychiatry & Neurology Addiction Psychiatry | |
| 2084P0805X Psychiatry & Neurology Geriatric Psychiatry | |
| 2084P2900X Psychiatry & Neurology Pain Medicine | |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2016-04-25 |