LCH-PEDS BEHAVIORAL HEALTH LA – NPI #1366179806
Clinic/Center

LCH-PEDS BEHAVIORAL HEALTH LA is an AHC clinic located in LEHIGH ACRES, FL. NPPES has assigned the NPI number 1366179806 to LCH-PEDS BEHAVIORAL HEALTH LA on August 04, 2022. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “LCH-PEDS BEHAVIORAL HEALTH LA” is a dba name, the actual legal business name for this organization is LEE MEMORIAL HEALTH SYSTEM. The primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

The NPI profile was last updated on Jul 24, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for LCH-PEDS BEHAVIORAL HEALTH LA below.

NPI Profile for
LEE MEMORIAL HEALTH SYSTEM

NPI Number
1366179806
Enumeration Date

(about 4 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
LEE MEMORIAL HEALTH SYSTEM
Doing Business As (dba): LCH-PEDS BEHAVIORAL HEALTH LA
Primary location
3415 LEE BLVD STE 301
LEHIGH ACRES, FL 33971-1576
Phone: (239) 343-6050 Fax: (239) 343-6051
Mailing address
PO BOX 2147
FORT MYERS, FL 33902-2147
Phone: (239) 343-6050 Fax: (239) 343-4255
Organization Subpart
No
Authorized Official
JOSEPH NIEBERGALL
CREDENTIALING SPECIALIST
Phone: (239) 424-1446
Updated
Certification Date
Jul 24, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC) (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.