Meridian Behavioral

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

License

PN 5213898 Issued in FL

Legal business name

MERIDIAN BEHAVIORAL

Practice address

4300 SW 13TH St
Gainesville, FL 32608-4006

Phone

(352) 374-5600

NPI assigned

Jul 18, 2015

Organization subpart

No

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

Authorized official

Name

Lacey Henderson

Title

LPN

Phone

(386) 292-1097

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

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

{
    "created_epoch": "1437177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437177600000",
    "number": "1992189013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 SW 13TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326084006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 SW 13TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326084006",
            "telephone_number": "352-374-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIAN BEHAVIORAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-18",
        "last_updated": "2015-07-18",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "LACEY",
        "authorized_official_title_or_position": "LPN",
        "authorized_official_telephone_number": "386-292-1097"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "FL",
            "license": "PN 5213898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yasser Merdad
• Meredith Goodrich DMD, PA
• Jason Andrew Meredith, C.T.R.S.
• Rebecca Meredith
• Antony Merendino, DPM
• Meridian Behavioral Healthcare
• Meridian Behavioral Healthcare
• Meridian Behavioral Healthcare Inc
• Meridian Behavioral Healthcare Inc.
• Meridian Behavioral Healthcare of Gainesville Case Management

• Custodial Care Facility in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Custodial Care Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.