Provider Demographics
NPI:1396202263
Name:THE GOOD SAMARITAN, INC.
Entity Type:Organization
Organization Name:THE GOOD SAMARITAN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:MAGEE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:727-475-6427
Mailing Address - Street 1:4201 6TH ST W
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33971-1254
Mailing Address - Country:US
Mailing Address - Phone:727-475-6427
Mailing Address - Fax:
Practice Address - Street 1:4201 6TH ST W
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33971-1254
Practice Address - Country:US
Practice Address - Phone:727-475-6427
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-26
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty