Organization
MISTY MOUNTAIN FAMILY ENRICHMENT CENTER
Active
Other names
Southwest Florida Christian Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY ALAN HASEK MA/MFT LPC, LMHC (EXECUTIVE DIRECTOR)
(239) 301-4464
Entity
Organization
Contact information
Practice address
24840 BURNT PINE DR, SUITES 1 & 2, BONITA SPRINGS, FL 34134-2999
(239) 301-4464
Mailing address
24840 BURNT PINE DR, SUITES 1 & 2, BONITA SPRINGS, FL 34134-2999
(239) 301-4464
(503) 684-6289
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MH 13637
FL
Other
Enumeration date
12/13/2009
Last updated
08/23/2016
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