Lifestream Behavioral Center INC
Psychiatric Hospital in Leesburg, FL. Organization (NPI-2).
NPI number1902802002
StatusActive
Last updated in NPPESJul 18, 2012
Details
- NPI
- 1902802002
- Entity type
- Organization (NPI-2)
- Legal business name
- Lifestream Behavioral Center INC
- Organization subpart
- No
- Enumeration date
- Jun 23, 2005
- Last updated
- Jul 18, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 283Q00000X | Psychiatric Hospital | 4075 | FL | Yes |
| 323P00000X | Psychiatric Residential Treatment Facility | – | – | |
| 251B00000X | Case Management | – | – | |
| 2084P0800X | Psychiatry & Neurology, Psychiatry | – | – | |
| 103TC2200X | Psychologist, Clinical Child & Adolescent | – | – | |
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – |
Practice location
2020 Talley RdLeesburg, FL 34748-3426
Phone 352-315-7800 · Fax 352-315-6595
Mailing address
Po Box 491000Leesburg, FL 34749-1000
Phone 352-315-7500 · Fax 352-360-6595
Authorized official
Carol E Dozier
Cfo
3523157532
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