Organization
LIFE MOVEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRUDY FARRIER LCSW (OWNER)
(954) 789-5148
Entity
Organization
Contact information
Practice address
13020 LAKE MEADOW DR, FORT MYERS, FL 33913-6918
(954) 789-5148
Mailing address
13020 LAKE MEADOW DR, FORT MYERS, FL 33913-6918
(954) 789-5148
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
07/20/2023
Last updated
07/20/2023
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