| Lifestream Behavioral Center Inc | |
|
215 N 3rd St Leesburg FL 34748-5105 | |
| (352) 315-7900 | |
| (352) 360-6582 |
| Full Name | Lifestream Behavioral Center Inc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 215 N 3rd St, Leesburg, Florida |
| Authorized Official Name and Position | Carol E Dozier (CPA) |
| Authorized Official Contact | 3523157532 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifestream Behavioral Center Inc Po Box 491000 Leesburg FL 34749-1000 Ph: (352) 315-7500 | Lifestream Behavioral Center Inc 215 N 3rd St Leesburg FL 34748-5105 Ph: (352) 315-7900 |
| NPI Number | 1659613776 |
|---|---|
| Provider Enumeration Date | 03/27/2013 |
| Last Update Date | 03/27/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659613776 | NPI | - | NPPES |
| 024576301 | Medicaid | FL | |
| 98270 | Other | FL | MEDICARE GROUP NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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