| NPI | 1831818582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA THOMAS Clinical Director 239-823-5745 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-08-25 |
| Last Update Date | 2022-08-25 |