Organization
THE SALVATION ARMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIM J MCCORMICK (DIRECTOR OF CORRECTIONS)
(239) 332-0140
Entity
Organization
Contact information
Practice address
2400 EDISON AVE, FORT MYERS, FL 33901-5106
(239) 332-0140
Mailing address
2400 EDISON AVE, FORT MYERS, FL 33901-5106
(239) 332-0140
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
3601
FL
Other
Enumeration date
06/24/2016
Last updated
07/21/2022
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