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NPI Code Detail

MEDICARE: MERIDIAN BEHAVIORAL HEALTHCARE, INC.

MEDICARE: MERIDIAN BEHAVIORAL HEALTHCARE, 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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
2251S00000XCommunity/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 : 1558538942
Entity Type Code : Organization
Provider Name (Legal Business Name) : MERIDIAN BEHAVIORAL HEALTHCARE, INC.
Provider Business Mailing Address
First Line : 1565 SW WILLISTON RD
Second Line :
City : GAINESVILLE
State : FL
Zip : 32608-4044
Country : US
Telephone Number : 352-374-5600
Fax Number : 352-244-0280
Provider Business Practice Location Address
First Line : 945 GRAND ST
Second Line :
City : STARKE
State : FL
Zip : 32091-1821
Country : US
Telephone Number : 904-964-8382
Fax Number : 904-964-4827
Authorized Official
Title or Position : SVP / CHIEF PERFORMANCE OFFICER
Name : LAUREN COHN
Credential :
Telephone Number : 352-374-5600
Provider Enumeration Date : 05/14/2008
Last Update Date : 10/21/2019

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Directions to “MERIDIAN BEHAVIORAL HEALTHCARE, INC. ” Practice Location

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