MEDICARE: LIFESKILLS SOUTH FLORIDA OUTPATIENT LLC

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
1	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1154293488
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFESKILLS SOUTH FLORIDA OUTPATIENT LLC

Provider Business Mailing Address
First Line	:	720 COOL SPRINGS BLVD STE 550
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-2645
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2145 METROCENTER BLVD STE 375
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-7643
Country	:	US
Telephone Number	:	407-802-5566
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	BENJAMIN BRADY
Credential	:
Telephone Number	:	615-864-8145

Provider Enumeration Date	:	09/17/2025
Last Update Date	:	04/06/2026

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