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General NPI Number Information
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NPI Number | 1518203033
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Entity Type | Organization
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Legal Business Name | DAVID LAAWRENCE CENTER
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Dates
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Enumeration Date | 01/02/2013
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Last Update Date | 03/18/2020
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Provider Practice Location Address
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Address Line | 2806 HORSESHOE DR S
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City | NAPLES
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State | FL
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Zip | 34104-6125
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Country | US
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Telephone | 239-451-6226
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Fax |
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Provider Business Mailing Address
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Address Line | 2806 HORSESHOE DR S
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City | NAPLES
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State | FL
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Zip | 34104-6125
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. SCOTT BURGESS
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Credential |
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Telephone | 239-451-6226
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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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