Organization
MERIDIAN BEHAVIORAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LACEY HENDERSON (LPN)
(386) 292-1097
Entity
Organization
Contact information
Practice address
4300 SW 13TH ST, GAINESVILLE, FL 32608-4006
(352) 374-5600
Mailing address
4300 SW 13TH ST, GAINESVILLE, FL 32608-4006
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
PN 5213898
FL
Other
Enumeration date
07/18/2015
Last updated
07/18/2015
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