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Organization
FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES
Active
Organization
FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES
Active
Other names
Florida State Hospital-Unit 31
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN B LEWALLEN (HOSPITAL ADMINISTRATOR)
(850) 663-7536
Entity
Organization
Contact information
Practice address
100 N MAIN ST, UNIT 31, BLDG 1243, CHATTAHOOCHEE, FL 32324-1107
(850) 663-7802
(850) 663-7516
Mailing address
100 N MAIN ST, MEDICARE BILLING DEPT. BLDG 1260, 3RD FLOOR, CHATTAHOOCHEE, FL 32324-1107
(850) 663-7802
(850) 663-7516
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
3990
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
011978400
—
FL
05
—
104294700
—
FL
05
—
270014000
—
FL
Enumeration date
05/03/2006
Last updated
11/18/2020
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