PEACE RIVER CENTER
NPI 1114673589
Psychiatry & Neurology - Psychiatry in Lakeland, FL
NPI Status: Active since February 24, 2022
Contact Information
230 S LAKE PARKER AVE
LAKELAND, FL
ZIP 33801
Phone: (863) 519-0575
Fax: (863) 582-9251
- Organization
- Psychiatry & Neurology
- Psychiatry
- CLIA Number: 10D2132695
- CLIA Cert. Type: Other - MENTAL HEALTH RESIDENTIAL
- CLIA Exp. Date: 06-26-2027
About PEACE RIVER CENTER
This page provides the complete NPI Profile along with additional information for Peace River Center, a provider established in Lakeland, Florida operating as a Psychiatry & Neurology, focusing in psychiatry . The healthcare provider is registered in the NPI registry with number 1114673589 assigned on February 2022. The practitioner's primary taxonomy code is 2084P0800X. The provider is registered as an organization and their NPI record was last updated 3 years ago. Peace River Center operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Peace River Center. The authorized official of this NPI record is Jo Deck Ba, Cpc (Credentialing Specialist)
- NPI
- 1114673589
- Provider Legal Name
- PEACE RIVER CENTER FOR PERSONAL DEVELOPMENT INC
- Other Organization Name
- PEACE RIVER CENTER
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 230 S LAKE PARKER AVE LAKELAND, FL 33801
- Location Phone
- (863) 519-0575
- Location Fax
- (863) 582-9251
- Mailing Address
- PO BOX 1559 BARTOW, FL 33831
- Mailing Phone
- (863) 519-0575
- Mailing Fax
- (863) 582-9251
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-24-2022
- Last Update Date
- 05-24-2023
- Code Navigator
A psychiatrist like Peace River Center are primary mental health physicians diagnose and treat mental illnesses through psychotherapy, psychoanalysis, hospitalization and medication. Psychiatrist help patients find solutions through changes in their behavioral patterns, explorations of experiences, group and family therapy.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Psychiatry & Neurology Psychiatry
- Taxonomy Code
- 2084P0800X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 060310423 | MEDICAID (05) | FL |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 10D2132695
- Facility Type
- Other - MENTAL HEALTH RESIDENTIAL
- Certificate Effective Date
- June 27, 2025
- Certificate Expiration Date
- June 26, 2027
- Laboratory Director
- MIGNON P. BURR
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Peace River Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1114673589, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 61 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
LAKELAND, FL 33801
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1114673589, enumerated as an "organization" on February 24, 2022.
The provider is located at 230 S LAKE PARKER AVE LAKELAND, FL 33801 and the phone number is (863) 519-0575.
Psychiatry & Neurology with taxonomy code 2084P0800X and a focus in Psychiatry.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
