Organization
LEE MEMORIAL HEALTH SYSTEM
Active
Other names
LCH- Peds Behavioral Health GN BCH
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH NIEBERGALL (CREDENTIALING SPECIALIST)
(239) 424-1446
Entity
Organization
Contact information
Practice address
3501 HEALTH CENTER BLVD STE 2190, ESTERO, FL 34135-8133
(239) 343-6050
(239) 343-6051
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-6050
(239) 343-4257
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
08/01/2022
Last updated
12/01/2022
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