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NPI Code Detail

MEDICARE: MERIDIAN BEHAVIORAL HEALTHCARE

MEDICARE: MERIDIAN BEHAVIORAL HEALTHCARE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073780318
Entity Type Code : Organization
Provider Name (Legal Business Name) : MERIDIAN BEHAVIORAL HEALTHCARE
Provider Business Mailing Address
First Line : 945 GRAND ST
Second Line :
City : STARKE
State : FL
Zip : 32091-1821
Country : US
Telephone Number : 904-964-4827
Fax Number :
Provider Business Practice Location Address
First Line : 945 GRAND ST
Second Line :
City : STARKE
State : FL
Zip : 32091-1821
Country : US
Telephone Number : 904-964-4827
Fax Number :
Authorized Official
Title or Position : BILLING DIRECTOR
Name : HEATHER RUPERT
Credential :
Telephone Number : 352-374-5600
Provider Enumeration Date : 05/15/2008
Last Update Date : 05/15/2008

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Directions to “MERIDIAN BEHAVIORAL HEALTHCARE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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