# CLEMENTINE BEHAVIORAL HEALTH, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508721093
- **Authorized official:** MRS. CALLIE JANE BAIRD (MANAGING MEMBER)
- **Authorized official phone:** (813) 422-0321

## Contact information

- **Practice address:** 212 W PARK ST, LAKELAND, FL 33803-1226
- **Practice address phone:** (813) 422-0321
- **Practice address fax:** (863) 213-0711
- **Mailing address:** 212 W PARK ST, LAKELAND, FL 33803-1226
- **Mailing address phone:** (813) 422-0321
- **Mailing address fax:** (863) 213-0711

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103K00000X | Behavior Analyst | — | NULL | Yes |
| 103K00000X | Behavior Analyst | — | — | Yes |

## Other

- **Enumeration date:** 12/17/2025
- **Last updated:** 02/16/2026