Organization
PROTECTED HARBOR INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES PERRY DUNCAN (MANAGER)
(239) 278-0200
Entity
Organization
Contact information
Practice address
4561 CAMINO REAL WAY, FORT MYERS, FL 33966-1026
(239) 278-0200
Mailing address
4561 CAMINO REAL WAY, FORT MYERS, FL 33966-1026
(239) 278-0200
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
10001700
FL
Other
Enumeration date
12/26/2017
Last updated
12/26/2017
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