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General NPI Number Information
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NPI Number | 1578895470
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Entity Type | Organization
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Legal Business Name | FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES
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Dates
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Enumeration Date | 02/03/2010
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Last Update Date | 11/18/2020
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Provider Practice Location Address
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Address Line | 100 N MAIN ST
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City | CHATTAHOOCHEE
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State | FL
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Zip | 32324-1107
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Country | US
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Telephone | 850-663-7802
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Fax | 850-663-7516
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Provider Business Mailing Address
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Address Line | 100 N MAIN ST FINANCIAL SVCS., BLDG 1260, 3RD FLOOR
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City | CHATTAHOOCHEE
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State | FL
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Zip | 32324-1107
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Country | US
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Telephone | 850-663-7802
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Fax | 850-663-7516
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Authorized Official
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Title or Position | HOSPITAL ADMINISTRATOR
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Name | MR. STEPHEN B LEWALLEN
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Credential |
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Telephone | 850-663-7536
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 3990
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License Number State | FL
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