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Organization

FAMILY PRESERVATION SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GERARD V SPRAGUE LMHC (CLINICAL SUPERVISOR)
(239) 332-8009
Entity
Organization

Contact information

Practice address
2180 MARAVILLA LN, FORT MYERS, FL 33901-7221
(239) 332-8009
(239) 332-4977
Mailing address
2180 MARAVILLA LN, FORT MYERS, FL 33901-7221
(239) 332-8009
(239) 332-4977

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1063528560
FL

Other

Enumeration date
05/12/2011
Last updated
05/12/2011
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