Healthcare Provider Details

I. General information

NPI: 1841654639
Provider Name (Legal Business Name): LIVING STONES BEHAVIORAL HEALTH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2016
Last Update Date: 05/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 W OAKLAND AVE SUITE A9
OAKLAND FL
34787-1802
US

IV. Provider business mailing address

940 W OAKLAND AVE SUITE A9
OAKLAND FL
34787-1802
US

V. Phone/Fax

Practice location:
  • Phone: 407-446-9814
  • Fax: 407-540-9683
Mailing address:
  • Phone: 407-446-9814
  • Fax: 407-540-9683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number12345
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number12345
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number12345
License Number StateFL
# 5
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateFL

VIII. Authorized Official

Name: ERSKIN BELL
Title or Position: PRESIDENT
Credential:
Phone: 407-446-9814