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NPI Code Detail

MEDICARE: BOYS TOWN NORTH FLORIDA, INC

MEDICARE: BOYS TOWN NORTH FLORIDA, 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
1322D00000XEmotionally Disturbed Childrens' Residential Treatment Facility0700-01-06FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285711960
Entity Type Code : Organization
Provider Name (Legal Business Name) : BOYS TOWN NORTH FLORIDA, INC
Provider Business Mailing Address
First Line : 3555 COMMONWEALTH BLVD
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32303-3119
Country : US
Telephone Number : 850-575-6422
Fax Number : 850-575-7158
Provider Business Practice Location Address
First Line : 3555 COMMONWEALTH BLVD
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32303-3119
Country : US
Telephone Number : 850-575-6422
Fax Number : 850-575-7158
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. MARCUS LAMPKIN
Credential :
Telephone Number : 850-504-5017
Provider Enumeration Date : 11/01/2006
Last Update Date : 03/01/2019

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Directions to “BOYS TOWN NORTH FLORIDA, INC ” Practice Location

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