Organization
LA AMISTAD RESIDENTIAL TREATMENT CENTER INC
Active
Parent organization
LAAMISTAD RESIDENTIAL TREATMENT CENTER INC
Other names
Central Florida Behavioral Hospital Physician Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAAMISTAD RESIDENTIAL TREATMENT CENTER INC
Authorized official
VICKIE LEWIS (CEO)
(407) 370-0111
Entity
Organization
Contact information
Practice address
6601 CENTRAL FLORIDA PKWY, ORLANDO, FL 32821-8064
(407) 264-0111
(407) 264-7745
Mailing address
6601 CENTRAL FLORIDA PKWY, ORLANDO, FL 32821-8064
(407) 264-0111
(407) 264-7745
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
4498
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E2M
BCBS
FL
Enumeration date
06/06/2013
Last updated
06/06/2013
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