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General NPI Number Information
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NPI Number | 1316385586
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Entity Type | Organization
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Legal Business Name | LEE COUNTY COALITION FOR A DRUG-FREE SOUTHWEST FLORIDA
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Dates
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Enumeration Date | 06/11/2013
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Last Update Date | 06/11/2013
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Provider Practice Location Address
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Address Line | 3763 EVANS AVE SUITE 202
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City | FORT MYERS
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State | FL
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Zip | 33901-9302
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Country | US
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Telephone | 239-931-9317
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Fax |
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Provider Business Mailing Address
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Address Line | 3763 EVANS AVE SUITE 202
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City | FORT MYERS
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State | FL
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Zip | 33901-9302
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Country | US
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Telephone | 239-931-9317
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DEBORAH COMELLA
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Credential | BFA
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Telephone | 239-931-9317
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number | 858012588492C8
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License Number State | FL
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