Organization
LAKELAND REGIONAL HEALTH SYSTEMS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANCE GREEN (EVP/CFO)
(863) 687-1100
Entity
Organization
Contact information
Practice address
115 S MISSOURI AVE STE 101, LAKELAND, FL 33815-4601
(863) 687-1222
(863) 603-6546
Mailing address
1324 LAKELAND HILLS BLVD, ATTN: MANAGED CARE, LAKELAND, FL 33805-4543
(863) 687-1100
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
02/27/2025
Last updated
02/27/2025
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