Lifestream Behavioral Center Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 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

Last updated

Mar 27, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

LIFESTREAM BEHAVIORAL CENTER INCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Carol E Dozier, CFO

Title

Cpa

Phone

(352) 315-7532

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Lifestream Behavioral Center Inc

  • Psychiatric Hospital
  • Leesburg, FL
  • NPI 1902802002

  O20040618000512

  Same enrollment

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

CLIA laboratory certificates

Part of

Lifstream Behavioral Ce

Locations

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.

• Lifestream Behavioral Center Inc

  • Psychiatric Hospital
  • Leesburg, FL
  • NPI 1902802002
  NPPES parent name

Practitioners 180

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Julie Avescat, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Leesburg, FL
  • NPI 1063044584
  NPD
• Chantal P Baptiste, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Clermont, FL
  • NPI 1851867766
  NPD
• Samuel O Battle

  • Psychiatric/Mental Health Nurse Practitioner
  • Tampa, FL
  • NPI 1013635150
  NPD
• Adriana Bentum-Tilus, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Kissimmee, FL
  • NPI 1801330519
  NPD
• Brad Broyles, MD

  • Psychiatry Physician
  • Leesburg, FL
  • NPI 1629033493
  NPD
• Lailatullah Burgos, APRN, NP-C

  • Family Nurse Practitioner
  • Lecanto, FL
  • NPI 1285785428
  NPD
• Ann Marie Alicia Burke, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Leesburg, FL
  • NPI 1801364377
  NPD
• Julie M Conrad, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Clermont, FL
  • NPI 1639698822
  NPD
• Miguel Angel Correa, MD

  • Addiction Medicine (Family Medicine) Physician
  • Leesburg, FL
  • NPI 1710198239
  NPD
• David Abolarin Dada, M.D.

  • Psychiatry Physician
  • Orlando, FL
  • NPI 1558637363
  NPD
• Abid Darr, MD

  • Behavioral Neurology & Neuropsychiatry Physician
  • Leesburg, FL
  • NPI 1871940783
  NPD
• Andrea Loretta Ellis, FNP

  • Family Nurse Practitioner
  • Sanford, FL
  • NPI 1770070898
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364342400000",
    "number": "1659613776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 491000",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347491000",
            "telephone_number": "352-315-7500",
            "fax_number": "352-360-6582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N 3RD ST",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485105",
            "telephone_number": "352-315-7900",
            "fax_number": "352-360-6582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTREAM BEHAVIORAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIFESTREAM BEHAVIORAL CENTER INC",
        "enumeration_date": "2013-03-27",
        "last_updated": "2013-03-27",
        "status": "A",
        "authorized_official_last_name": "DOZIER",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CPA",
        "authorized_official_telephone_number": "352-315-7532",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "98270",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024576301",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David C Lew, M.D.
• Mary Beth Lewis-Boardman, MD
• LHCG CLV, LLC (Mederi Caretenders)
• David Richard Lichtinger, D.O.
• Life-Line Medical Transportation Inc.
• Lifestream Behavioral Center Inc
• William Lim, MD
• Limitless Care
• Centcha Limprevil, APRN
• Lincare Inc.

• Primary Care Clinic/Center in Leesburg, FL
• Providers in Leesburg, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.