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General NPI Number Information
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NPI Number | 1730163379
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Entity Type | Organization
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Legal Business Name | LISA MERLIN HOUSE, INC.
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Dates
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Enumeration Date | 12/06/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3101 N PINE HILLS RD
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City | ORLANDO
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State | FL
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Zip | 32808-3543
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Country | US
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Telephone | 407-292-0109
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Fax | 407-293-5709
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Provider Business Mailing Address
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Address Line | 3101 N PINE HILLS RD
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City | ORLANDO
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State | FL
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Zip | 32808-3543
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Country | US
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Telephone | 407-292-0109
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Fax | 407-293-5709
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MRS. LISA E MERLIN
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Credential |
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Telephone | 407-292-0109
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 0748AD260003
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License Number State | FL
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