Organization
LVH FL TELEHEALTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA LYNNE LASICK (DIRECTOR OF RCM)
(954) 559-1378
Entity
Organization
Contact information
Practice address
1900 CORPORATE SQUARE BLVD, JACKSONVILLE, FL 32216-1941
(904) 515-5086
(866) 541-5354
Mailing address
PO BOX 4458, DEPT 841, HOUSTON, TX 77210-4458
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
02/23/2021
Last updated
06/07/2021
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