Provider Demographics
NPI:1780184994
Name:MERIDIAN BEHAVIORAL HEALTHCARE, INC.
Entity Type:Organization
Organization Name:MERIDIAN BEHAVIORAL HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP / CHIEF PERFORMANCE 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 1:1565 SW WILLISTON RD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-4044
Mailing Address - Country:US
Mailing Address - Phone:352-374-5600
Mailing Address - Fax:352-244-0280
Practice Address - Street 1:103 NE 1ST ST
Practice Address - Street 2:
Practice Address - City:CHIEFLAND
Practice Address - State:FL
Practice Address - Zip Code:32626-0920
Practice Address - Country:US
Practice Address - Phone:800-330-5615
Practice Address - Fax:352-244-0280
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERIDIAN BEHAVIORAL HEALTHCARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-02-14
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)