Organization
EM LEGACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ERIN M PORTER LCSW (MNGR DIRECTOR)
(941) 545-9630
Entity
Organization
Contact information
Practice address
2605 72ND AVE E, 221, ELLENTON, FL 34222-7000
(941) 545-9630
Mailing address
2605 72ND AVE E, 221, ELLENTON, FL 34222-7000
(941) 545-9630
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW11139
FL
Other
Enumeration date
05/30/2014
Last updated
05/30/2014
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