Provider Demographics
NPI:1245687318
Name:LIFESTAIRS BEHAVIORAL HEALTH CENTER INC
Entity type:Organization
Organization Name:LIFESTAIRS BEHAVIORAL HEALTH CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MAJOR
Authorized Official - Middle Name:RAINIER
Authorized Official - Last Name:CAUSING
Authorized Official - Suffix:
Authorized Official - Credentials:CBHCMS
Authorized Official - Phone:407-780-0759
Mailing Address - Street 1:2925 E SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-6459
Mailing Address - Country:US
Mailing Address - Phone:818-428-5255
Mailing Address - Fax:188-834-4969
Practice Address - Street 1:2925 E SOUTH ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-6459
Practice Address - Country:US
Practice Address - Phone:818-428-5255
Practice Address - Fax:888-344-9692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-18
Last Update Date:2019-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty