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General NPI Number Information
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NPI Number | 1265744700
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL HEALTH ASSOCIATES, INC.
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Dates
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Enumeration Date | 07/13/2010
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Last Update Date | 07/13/2010
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Provider Practice Location Address
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Address Line | 1367 E LAFAYETTE ST SUITE B
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City | TALLAHASSEE
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State | FL
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Zip | 32301-4774
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Country | US
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Telephone | 850-325-6590
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Fax | 850-325-6591
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Provider Business Mailing Address
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Address Line | 1367 E LAFAYETTE ST SUITE B
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City | TALLAHASSEE
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State | FL
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Zip | 32301-4774
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Country | US
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Telephone | 850-325-6590
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Fax | 850-325-6591
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Authorized Official
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Title or Position | OWNER
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Name | MS. LOIS M LEISTNER
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Credential | A.R.N.P.
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Telephone | 850-325-6590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | ARNP1654742
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License Number State | FL
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