Provider Demographics
NPI:1396253027
Name:LANSHEL, INC.
Entity type:Organization
Organization Name:LANSHEL, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/ PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:K
Authorized Official - Last Name:LANGE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:954-401-5675
Mailing Address - Street 1:4850 W OAKLAND PARK BLVD STE 145
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33313-7277
Mailing Address - Country:US
Mailing Address - Phone:954-933-3407
Mailing Address - Fax:
Practice Address - Street 1:4850 W OAKLAND PARK BLVD STE 145
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33313-7277
Practice Address - Country:US
Practice Address - Phone:954-933-3407
Practice Address - Fax:754-205-4528
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LANSHEL INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-16
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107203000Medicaid
FL1336597590Medicaid