Organization
LIFESTREAM BEHAVIORAL CENTER INC
Active
Parent organization
LIFESTREAM BEHAVIORAL CENTER INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFESTREAM BEHAVIORAL CENTER INC
Authorized official
MS. CAROL E DOZIER CFO (CPA)
(352) 315-7532
Entity
Organization
Contact information
Practice address
215 N 3RD ST, LEESBURG, FL 34748-5105
(352) 315-7900
(352) 360-6582
Mailing address
PO BOX 491000, LEESBURG, FL 34749-1000
(352) 315-7500
(352) 360-6582
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024576301
—
FL
01
—
98270
MEDICARE GROUP NUMBER
FL
Enumeration date
03/27/2013
Last updated
03/27/2013
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