Organization
CENTERSTONE OF FLORIDA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEAN GINGRAS DOF (REGIONAL FINANCE OFFICER)
(941) 782-4299
Entity
Organization
Contact information
Practice address
2020 26TH AVE E, BRADENTON, FL 34208-7753
(941) 782-4600
(941) 782-4601
Mailing address
P.O. BOX 9478, BRADENTON, FL 34206-9478
(941) 782-4299
(941) 782-4301
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
12-41-AD-9537-01
FL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
12-41-AD-9537-03
FL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
12-41-AD-9537-05
FL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
12-41-AD-9537-06
FL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
12-41-AD-9537-07
FL
261QM1300X
Multi-Specialty Clinic/Center
—
—
273R00000X
Psychiatric Hospital Unit
1467
FL
283Q00000X
Psychiatric Hospital
3977
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004469301
—
FL
05
—
004469303
—
FL
05
—
004469304
—
FL
05
—
004469305
—
FL
05
—
060280900
—
FL
05
—
060280901
—
FL
05
—
060280905
—
FL
05
—
060280910
—
FL
05
—
260859600
—
FL
Enumeration date
07/05/2006
Last updated
11/27/2023
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