| NPI | 1902427644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN KAY HOOK Executive Director 239-257-3094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2020-05-05 |
| Last Update Date | 2020-08-27 |