Organization
FAMILY PRESERVATION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERARD SPRAGUE LMHC (SUPERVISOR)
(239) 332-8009
Entity
Organization
Contact information
Practice address
2180 MARAVILLA LN, FORT MYERS, FL 33901-7221
(239) 332-8009
Mailing address
2180 MARAVILLA LN, FORT MYERS, FL 33901-7221
(239) 332-8009
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
650848685
FL
Other
Enumeration date
07/02/2012
Last updated
07/02/2012
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