| Baptist Behavioral Health, Llc | |
|
3650 Nw Devane St Lake City FL 32055-8730 | |
| (904) 376-3800 | |
| (904) 376-3998 |
| Full Name | Baptist Behavioral Health, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 3650 Nw Devane St, Lake City, Florida |
| Authorized Official Name and Position | Elizabeth Tish De Medici (CREDENTIALING MGR) |
| Authorized Official Contact | 9043763800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Baptist Behavioral Health, Llc Po Box 748519 Atlanta GA 30374-8519 Ph: (904) 376-3800 | Baptist Behavioral Health, Llc 3650 Nw Devane St Lake City FL 32055-8730 Ph: (904) 376-3800 |
| NPI Number | 1295467207 |
|---|---|
| Provider Enumeration Date | 06/28/2022 |
| Last Update Date | 06/28/2022 |
| Certification Date | 06/28/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295467207 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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