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NPI Code Detail

MEDICARE: MERIDIAN BEHAVIORAL HEALTHCARE, INC.

MEDICARE: MERIDIAN BEHAVIORAL HEALTHCARE, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251B00000XCase Management Agency
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
3251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1265954358
Entity Type Code : Organization
Provider Name (Legal Business Name) : MERIDIAN BEHAVIORAL HEALTHCARE, INC.
Provider Business Mailing Address
First Line : 1565 SW WILLISTON RD
Second Line :
City : GAINESVILLE
State : FL
Zip : 32608-4044
Country : US
Telephone Number : 352-374-5600
Fax Number : 352-244-0280
Provider Business Practice Location Address
First Line : 92 W LOWDER ST
Second Line :
City : MACCLENNY
State : FL
Zip : 32063-2676
Country : US
Telephone Number : 352-374-5600
Fax Number : 352-244-0280
Authorized Official
Title or Position : PRESIDENT / CEO
Name : MARGARITA LABARTA
Credential : PH.D.
Telephone Number : 352-374-5600
Provider Enumeration Date : 07/11/2017
Last Update Date : 10/21/2019

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