| NPI | 1902173529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA FERRES Manager 239-768-6060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME0056944) |
| Enumeration Date | 2011-11-28 |
| Last Update Date | 2014-04-21 |