Peace River Center For Personal Development Inc

LBN: Peace River Center For Personal Development Inc
Peace River Center For Personal Development Inc is an health care organization with primary practice located at 1835 Gilmore Ave , Lakeland FL 33805-3017. The organization recently has only one registered license in Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), which is considered as the primary health care specialty. Peace River Center For Personal Development Inc can be contacted via phone (863) 519-0575, or through Deck, Jo via phone (863) 519-0575.

Contact Information

Primary practice address
1835 Gilmore Ave Lakeland FL 33805-3017
Phone: (863) 519-0575
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Deck, Jo BA, CPC
Phone: (863) 519-0575

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X

Profile Details

NPI number 1790430452
LBN Legal business name Peace River Center For Personal Development Inc
DBA Doing business as
Authorized official Deck, Jo BA, CPC
Entity Organization
Organization subpart 1 No
Enumeration date Feb 21st, 2022
Last updated Feb 21st, 2022 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790430452 NPPES
Florida MEDICAID 060310405

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