Provider Demographics
NPI:1467115824
Name:MERIDIAN BEHAVIORAL HEALTHCARE, INC.
Entity Type:Organization
Organization Name:MERIDIAN BEHAVIORAL HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVP / CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:COHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-374-5600
Mailing Address - Street 1:4300 SW 13TH ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-4006
Mailing Address - Country:US
Mailing Address - Phone:352-374-5600
Mailing Address - Fax:352-244-0308
Practice Address - Street 1:3314 CRILL AVE
Practice Address - Street 2:
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177-4162
Practice Address - Country:US
Practice Address - Phone:352-374-5600
Practice Address - Fax:352-244-0308
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERIDIAN BEHAVIORAL HEALTHCARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-10-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)