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General NPI Number Information
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NPI Number | 1003282583
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Entity Type | Organization
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Legal Business Name | MERIDIAN BEHAVIORIAL HEALTHCARE
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Dates
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Enumeration Date | 08/19/2015
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Last Update Date | 08/19/2015
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Provider Practice Location Address
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Address Line | 4300 SW 13TH ST
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City | GAINESVILLE
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State | FL
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Zip | 32608-4006
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Country | US
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Telephone | 352-374-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 4300 SW 13TH ST.
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City | GAINESVILLE
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State | FL
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Zip | 32608-0468
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | RECRUTING MANAGER
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Name | DANNY ANDERSON
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Credential |
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Telephone | 352-374-5600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number | 221324
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License Number State | FL
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