Organization
LIFESTREAM BEHAVIORAL CENTER INC
Active
Organization
LIFESTREAM BEHAVIORAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROL E DOZIER CPA (CFO)
(352) 315-7532
Entity
Organization
Contact information
Practice address
2020 TALLEY RD, LEESBURG, FL 34748-3426
(352) 315-7800
(352) 315-6595
Mailing address
PO BOX 491000, LEESBURG, FL 34749-1000
(352) 315-7500
(352) 360-6595
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
2084P0800X
Psychiatry Physician
—
—
251B00000X
Case Management Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
283Q00000X
Psychiatric Hospital
Primary
4075
FL
323P00000X
Psychiatric Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024576301
—
FL
05
—
060334100
—
FL
05
—
060334102
—
FL
05
—
060334105
—
FL
05
—
060334108
—
FL
01
—
151443
WELLCARE PROVIDER #
FL
05
—
360181100
—
FL
01
—
98270
BCBS OUTPATIENT NUMBER
FL
01
—
E-83
BCBS INPATIENT NUMBER
FL
Enumeration date
06/23/2005
Last updated
07/18/2012
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up