Provider Demographics
NPI:1033817457
Name:CENTERPLACE HEALTH, INC
Entity Type:Organization
Organization Name:CENTERPLACE HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KARI
Authorized Official - Middle Name:AUD
Authorized Official - Last Name:ELLINGSTAD
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:941-529-2422
Mailing Address - Street 1:1750 17TH ST STE N
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34234-8690
Mailing Address - Country:US
Mailing Address - Phone:941-529-0200
Mailing Address - Fax:
Practice Address - Street 1:6919 OUTREACH WAY
Practice Address - Street 2:
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34287-3493
Practice Address - Country:US
Practice Address - Phone:941-529-0200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTERPLACE HEALTH, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)