| NPI | 1790519916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH NOEMI DOSORETZ CEO 239-223-2751 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101Y00000X Counselor |
| 103K00000X Behavior Analyst | |
| 103TC0700X Psychologist Clinical | |
| 104100000X Social Worker | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2024-08-29 |
| Last Update Date | 2025-06-05 |