| NPI | 1801891940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT BURGESS CEO 239-455-8500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2020-03-18 |