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General NPI Number Information
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NPI Number | 1245687318
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Entity Type | Organization
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Legal Business Name | LIFESTAIRS BEHAVIORAL HEALTH CENTER INC
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Dates
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Enumeration Date | 05/18/2016
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Last Update Date | 05/12/2019
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Provider Practice Location Address
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Address Line | 2925 E SOUTH ST
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City | ORLANDO
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State | FL
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Zip | 32803-6459
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Country | US
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Telephone | 818-428-5255
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Fax | 888-344-9692
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Provider Business Mailing Address
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Address Line | 2925 E SOUTH ST
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City | ORLANDO
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State | FL
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Zip | 32803-6459
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Country | US
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Telephone | 818-428-5255
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Fax | 188-834-4969
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MAJOR RAINIER CAUSING
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Credential | CBHCMS
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Telephone | 407-780-0759
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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