Provider Demographics
NPI:1366816118
Name:OCALA BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:OCALA BEHAVIORAL HEALTH LLC
Other - Org Name:THE VINES HOSPITAL PHYSICIAN GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINTYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-671-3130
Mailing Address - Street 1:3130 SW 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-4306
Mailing Address - Country:US
Mailing Address - Phone:352-671-3130
Mailing Address - Fax:352-387-0767
Practice Address - Street 1:3130 SW 27TH AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-4306
Practice Address - Country:US
Practice Address - Phone:352-671-3130
Practice Address - Fax:352-387-0767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-17
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility