Peace River Center

LBN: Peace River Center For Personal Development Inc
Peace River Center is an health care organization with primary practice located at 1664 Williamsburg Sq , Lakeland FL 33803-4278. The organization recently has only one registered license in Agencies / Case Management, 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
1664 Williamsburg Sq Lakeland FL 33803-4278
Phone: (863) 519-0575
Fax: (863) 582-9251
Website:
Map and Directions
Authorized official contact:
Name: Deck, Jo BA, CPC
Phone: (863) 519-0575

Health care specialties

SpecialtyCodeLicense #State
Agencies / Case Management 251B00000X

Profile Details

NPI number 1790431146
LBN Legal business name Peace River Center For Personal Development Inc
DBA Doing business as Peace River Center
Authorized official Deck, Jo BA, CPC
Entity Organization
Organization subpart 1 No
Enumeration date Feb 24th, 2022
Last updated May 24th, 2023 - about 2 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 1790431146 NPPES
Florida MEDICAID 060310419

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