Healthcare Provider Details
I. General information
NPI: 1629241229
Provider Name (Legal Business Name): MERIDIAN BEHAVIORAL HEALTHCARE OF GAINESVILLE CASE MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/04/2008
Last Update Date: 04/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4300 SW 13TH ST
GAINESVILLE FL
32608-4006
US
IV. Provider business mailing address
4300 SW 13TH ST
GAINESVILLE FL
32608-4006
US
V. Phone/Fax
- Phone: 352-374-5600
- Fax:
- Phone: 352-374-5600
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MARGARITA
LABARTA
Title or Position: PRESIDENT/CEO
Credential: PHD
Phone: 352-374-5600