MEDICARE: LIFESKILLS SOUTH FLORIDA OUTPATIENT LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1780941112
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFESKILLS SOUTH FLORIDA OUTPATIENT LLC

Provider Business Mailing Address
First Line	:	720 COOL SPRINGS BLVD STE 550
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-2645
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	440 SE 5TH AVE
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33483-5211
Country	:	US
Telephone Number	:	954-284-0495
Fax Number	:	954-834-5082

Authorized Official
Title or Position	:	CFO
Name	:	BENJAMIN BRADY
Credential	:
Telephone Number	:	615-864-8145

Provider Enumeration Date	:	04/23/2012
Last Update Date	:	04/06/2026

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