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NPI Code Detail

MEDICARE: LIFESTAIRS BEHAVIORAL HEALTH CENTER INC

MEDICARE: LIFESTAIRS BEHAVIORAL HEALTH CENTER INC
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
1103K00000XBehavior Analyst
2251B00000XCase Management Agency
3251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1245687318
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIFESTAIRS BEHAVIORAL HEALTH CENTER INC
Provider Business Mailing Address
First Line : 2925 E SOUTH ST
Second Line :
City : ORLANDO
State : FL
Zip : 32803-6459
Country : US
Telephone Number : 818-428-5255
Fax Number : 188-834-4969
Provider Business Practice Location Address
First Line : 2925 E SOUTH ST
Second Line :
City : ORLANDO
State : FL
Zip : 32803-6459
Country : US
Telephone Number : 818-428-5255
Fax Number : 888-344-9692
Authorized Official
Title or Position : ADMINISTRATOR
Name : MAJOR RAINIER CAUSING
Credential : CBHCMS
Telephone Number : 407-780-0759
Provider Enumeration Date : 05/18/2016
Last Update Date : 05/12/2019

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