Lifestream Behavioral Center Inc in Leesburg - Clinical Child & Adolescent
Lifestream Behavioral Center Inc - NPI 1902802002
Lifestream Behavioral Center Inc is a Clinical Child & Adolescent in Leesburg, Florida. Lifestream Behavioral Center Inc practices all healthcare services and medical treatments related to Clinical Child & Adolescent. The NPI Number for Lifestream Behavioral Center Inc is 1902802002. The last update date is 2012-07-18.
Lifestream Behavioral Center Inc's current location address is 2020 Talley Rd, Leesburg, Florida. You can contact this provider via phone number 3523157800 and fax number 3523156595. The mailing address for Lifestream Behavioral Center Inc is 2020 Talley Rd, Leesburg, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Lifestream Behavioral Center Inc |
|---|---|
| Address | 2020 Talley Rd, Leesburg, Florida |
| Phone Number | 3523157800 |
| Fax Number | 3523156595 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CFO |
|---|---|
| Authorized Official Name | Dozier E Carol |
| Credentials | CPA |
| Telephone Number | 3523157532 |
NPI Number Detail
| NPI Number | 1902802002 |
|---|---|
| Provider Enumeration Date | 2005-06-23 |
| Last Updated Date | 2012-07-18 |
Provider Mailing Address Detail
| Address | 2020 Talley Rd |
|---|---|
| City | Leesburg |
| State | Florida (FL) |
| Post Code | 3474834260 |
| Phone Number | 3523157800 |
| Fax Number | 3523156595 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical Child & Adolescent |
|---|---|
| Taxonomy | 103Tc2200X |
|
Definition: A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 60334100 | FL | -- | |
| 151443 | FL | WELLCARE PROVIDER # | |
| 60334108 | FL | -- | |
| 60334102 | FL | -- | |
| 98270 | FL | BCBS OUTPATIENT NUMBER | |
| E-83 | FL | BCBS INPATIENT NUMBER | |
| 24576301 | FL | -- | |
| 60334105 | FL | -- | |
| 360181100 | FL | -- |
Post Comment/ Review Below
What is the Lifestream Behavioral Center Inc's 1902802002?
The Lifestream Behavioral Center Inc's NPI (National Provider Identifier) Number is 1902802002. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Lifestream Behavioral Center Inc's physical address?
The Lifestream Behavioral Center Inc is physically located at 2020 Talley Rd, in the city of Leesburg, FL, with the postal code 3474834260.
What is Lifestream Behavioral Center Inc's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Lifestream Behavioral Center Inc is Clinical Child & Adolescent, and the taxonomy code that categorizes this field of expertise is 103Tc2200X.
On what date did the Centers for Medicare & Medicaid Services issue the 1902802002 to Lifestream Behavioral Center Inc?
The Lifestream Behavioral Center Inc received its 1902802002 assignment from the Centers for Medicare & Medicaid Services on 2005-06-23.
When was the information pertaining to Lifestream Behavioral Center Inc most recently updated or revised?
The details related to Lifestream Behavioral Center Inc, including its address, specialty, and other relevant information, were last updated or revised on 2012-07-18.
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