Provider Demographics
NPI:1053643635
Name:BLUE HORIZON EATING DISORDER SERVICES, LLC
Entity Type:Organization
Organization Name:BLUE HORIZON EATING DISORDER SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:S
Authorized Official - Last Name:BEERBOWER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, LD/N
Authorized Official - Phone:407-960-2651
Mailing Address - Street 1:1155 LOUISIANA AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-2341
Mailing Address - Country:US
Mailing Address - Phone:407-960-2651
Mailing Address - Fax:407-335-4964
Practice Address - Street 1:1155 LOUISIANA AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-2341
Practice Address - Country:US
Practice Address - Phone:407-960-2651
Practice Address - Fax:407-335-4964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-05
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH13519101YM0800X
FLMT1946106H00000X
FLND0001484133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty