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General NPI Number Information
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NPI Number | 1497324495
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Entity Type | Organization
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Legal Business Name | CENTERSTONE OF FLORIDA, INC.
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Dates
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Enumeration Date | 06/23/2021
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 4350 FOWLER ST
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City | FORT MYERS
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State | FL
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Zip | 33901-2699
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Country | US
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Telephone | 941-782-4150
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9478
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City | BRADENTON
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State | FL
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Zip | 34206-9478
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Country | US
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Telephone | 941-782-4150
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Fax | 941-782-4301
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Authorized Official
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Title or Position | REGIONAL FINANCE OFFICER
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Name | SEAN GINGRAS
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Credential |
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Telephone | 941-782-4299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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