| NPI | 1952967887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAYTON LAMBERT MAJOR Co Owner 239-822-8401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2019-05-16 |
| Last Update Date | 2019-05-16 |