Organization
FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES
Active
Parent organization
FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES
Other names
Florida State Hospital
Organization subpart
Yes
Provider details
NPI number
Legal business name
FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES
Authorized official
MR. STEPHEN B LEWALLEN (HOSPITAL ADMINISTRATOR)
(850) 663-7536
Entity
Organization
Contact information
Practice address
100 N MAIN ST, CHATTAHOOCHEE, FL 32324-1107
(850) 663-7802
(850) 663-7516
Mailing address
100 N MAIN ST, FINANCIAL SVCS., BLDG 1260, 3RD FLOOR, CHATTAHOOCHEE, FL 32324-1107
(850) 663-7802
(850) 663-7516
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
3990
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026001100
—
FL
Enumeration date
02/03/2010
Last updated
11/18/2020
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