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General NPI Number Information
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NPI Number | 1801891940
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Entity Type | Organization
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Legal Business Name | DAVID LAWRENCE MENTAL HEALTH CENTER, INC
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 03/18/2020
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Provider Practice Location Address
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Address Line | 6075 BATHEY LN
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City | NAPLES
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State | FL
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Zip | 34116-7536
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Country | US
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Telephone | 239-455-8500
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Fax | 239-455-6561
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Provider Business Mailing Address
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Address Line | 6075 BATHEY LN
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City | NAPLES
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State | FL
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Zip | 34116-7536
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Country | US
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Telephone | 239-455-8500
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Fax | 239-455-6561
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Authorized Official
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Title or Position | CEO
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Name | SCOTT BURGESS
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Credential |
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Telephone | 239-455-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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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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