Organization
LOVED ONES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KHADIJAH GILES (PRESIDENT)
(239) 634-7939
Entity
Organization
Contact information
Practice address
9550 ROUNDSTONE CIR, FORT MYERS, FL 33967-5143
(239) 634-7939
Mailing address
9550 ROUNDSTONE CIR, FORT MYERS, FL 33967-5143
(239) 634-7939
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
04/14/2026
Last updated
04/14/2026
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