Libre Behavioral Healthcare LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

LIBRE BEHAVIORAL HEALTHCARE LLC

Practice address

3930 S Nova Rd Ste 106
Port Orange, FL 32127-9293

Phone

(386) 492-6894

Fax

(407) 522-9343

NPI assigned

Oct 20, 2017

Organization subpart

No

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

Authorized official

Name

Mark Nagrani, MD

Title

Owner

Phone

(407) 522-9919

Specialties & licenses 1

Addresses

Other names 1

• Coastal Behavioral Doing business as

Locations

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

{
    "created_epoch": "1508457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508457600000",
    "number": "1760993430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 PALMETTO ST",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321687327",
            "telephone_number": "386-492-6894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 S NOVA RD STE 106",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321279293",
            "telephone_number": "386-492-6894",
            "fax_number": "407-522-9343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBRE BEHAVIORAL HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-20",
        "last_updated": "2017-10-20",
        "status": "A",
        "authorized_official_last_name": "NAGRANI",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-522-9919",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Behavioral",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cleophus Lewis
• Gwendolyn Lewis
• Ladon Stacy Lewis, L.M.T.
• Sara Lenoir Lewis
• Yanelis Leyva, MSN, FNP-BC
• Mary Kathleen Lichtenwalter, LMHC, CAP, CCS
• Wen-Ling Lin, APRN
• Lincare Pulmonary Rehab Services of Florida, PL
• Zachary Lindeman
• Carolyn Lipphardt

• Substance Abuse Rehabilitation Facility in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Substance Abuse Rehabilitation Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.