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General NPI Number Information
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NPI Number | 1336285634
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Entity Type | Organization
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Legal Business Name | LUTHERAN SERVICES FLORIDA, INC.
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3615 CENTRAL AVE SUITE 4
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City | FORT MYERS
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State | FL
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Zip | 33901-8257
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Country | US
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Telephone | 239-278-1140
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Fax | 239-275-8567
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Provider Business Mailing Address
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Address Line | 3615 CENTRAL AVE SUITE 4
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City | FORT MYERS
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State | FL
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Zip | 33901-8257
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Country | US
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Telephone | 239-278-1140
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Fax | 239-275-8567
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Authorized Official
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Title or Position | REGIONAL DIRECTOR
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Name | MRS. PATRICIA LEONARD
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Credential | L.C.S.W
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Telephone | 239-275-1126
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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