NPIMap

Lifestream Behavioral Center Inc

Organization Active NPI Primary Care Clinic/Center · Leesburg, FL

NPI 1659613776 · NPPES record last updated Mar 27, 2013

Key facts

NPI
1659613776
Entity type
Organization (NPI type 2)
Primary specialty
Primary Care Clinic/Center 261QP2300X
Legal business name
LIFESTREAM BEHAVIORAL CENTER INC
Practice address
215 N 3Rd St
Leesburg, FL 34748-5105
Phone
(352) 315-7900
Fax
(352) 360-6582
NPI assigned
Mar 27, 2013
Organization subpart
Yes
Parent organization (as reported)
LIFESTREAM BEHAVIORAL CENTER INC

Authorized official

Name
Ms. Carol E Dozier, CFO
Title
Cpa
Phone
(352) 315-7532

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 182

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 182

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2076168Lifestream Behavioral Center Inc
215 N 3Rd St, Leesburg, FL 34748		Certificate of waiverApr 13, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040618000512 FL Part B Supplier - Clinic/Group Practice 7012992720 Receives reassigned benefits from 39 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Brooksville, FL; Bushnell, FL; Clermont, FL; Eustis, FL; Umatilla, FL; Sumterville, FL; Ocoee, FL; Ocala, FL…

National Provider Directory

Part of
Lake Sumter Com MNTL HL

Locations

51 W Fort Dade Ave
Brooksville, FL 34601
Phone 3528483924 ext. 35284

4416 S US Highway 301
Bushnell, FL 33513
Phone (352) 793-4129

119 N Market St
Bushnell, FL 33513
Phone (352) 793-4126

2140 N Don Wickham Dr
Clermont, FL 34711
Phone (352) 394-5922

1554 N Meadowcrest Blvd
Crystal River, FL 34429
Phone (352) 228-4470

1217 Huffstetler Dr
Eustis, FL 32726
Phone (352) 483-1652

201 E Magnolia Ave
Eustis, FL 32726
Phone (352) 315-7100

115 E Citrus Ave
Eustis, FL 32726
Phone (352) 357-1500

3238 S Lecanto Hwy
Lecanto, FL 34461
Phone (352) 628-5020

3264 S Lecanto Hwy
Lecanto, FL 34461
Phone (352) 632-4500

2417 N Lecanto Hwy
Lecanto, FL 34461
Phone (352) 270-9009

2419 N Lecanto Hwy
Lecanto, FL 34461
Phone (352) 235-8771

800 Lee St
Leesburg, FL 34748
Phone (352) 315-3923

404 Webster St
Leesburg, FL 34748
Phone (352) 360-6506

515 W Main St
Leesburg, FL 34748
Phone (352) 315-7534

2020 Tally Rd
Leesburg, FL 34748
Phone (352) 315-7800

101 S 11th St
Leesburg, FL 34748
Phone (352) 787-8301

1017 W Dixie Ave
Leesburg, FL 34748
Phone (352) 315-3923

2018 Tally Rd
Leesburg, FL 34748
Phone (352) 315-7400

6215 Holly St
Mount Dora, FL 32757
Phone (352) 383-9242

1554 Boren Dr
Ste 100
Ocoee, FL 34761
Phone (407) 614-2715

314 Lagrande Blvd
The Villages, FL 32159
Phone (352) 259-5762

19812 E 5th St
Umatilla, FL 32784
Phone (352) 771-8996

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Yes

Addresses

Primary practice location

215 N 3Rd St
Leesburg, FL 34748-5105

Mailing address

PO Box 491000
Leesburg, FL 34749-1000
Phone (352) 315-7500

Other identifiers

IdentifierTypeStateIssuer
024576301MedicaidFL
98270OtherFLMEDICARE GROUP NUMBER

Other providers in Leesburg, FL

All providers in Leesburg, FL · Primary Care Clinic/Center in Florida

Sources for this page

Verify at the official NPI Registry.