Healthcare Provider Details

I. General information

NPI: 1033789052
Provider Name (Legal Business Name): CENTERSTONE OF FLORIDA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2021
Last Update Date: 06/30/2021
Certification Date: 06/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4010 SAWYER RD
SARASOTA FL
34233-1272
US

IV. Provider business mailing address

PO BOX 197515
NASHVILLE TN
37219-7515
US

V. Phone/Fax

Practice location:
  • Phone: 941-782-4150
  • Fax: 941-782-4898
Mailing address:
  • Phone: 941-782-4299
  • Fax: 941-782-4301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MOLLY CHRISTINE BISS
Title or Position: REVENUE CYCLE MANAGER
Credential:
Phone: 941-782-4206