PEACE RIVER CENTER
NPI 1174279582
Case Management in Bartow, FL

Q: What is Peace River Center For Personal Development Inc's specialty?

The primary specialty registered for this NPI is Case Management with taxonomy code 251B00000X.

Active since February 24, 2022CLIA 10D2152672 · Waiver

1239 E MAIN ST, BARTOW, FL 33830(863) 519-0575(863) 582-9251 Get Directions Write a Review

NPPES record last updated: February 13, 2023. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Feb 13, 2023, Feb 24, 2022 (2 updates tracked since 2022).

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About Peace River Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEACE RIVER CENTER (NPI 1174279582) is a healthcare organization registered as a case management in Bartow, Florida and active in the NPI registry since February 2022. The organization holds a CLIA Waiver certificate valid through August 13, 2028 and lists Jo Deck, Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1174279582

Entity TypeOrganization

Primary Taxonomy251B00000X

Legal Business NamePEACE RIVER CENTER FOR PERSONAL DEVELOPMENT INC

Location Address1239 E MAIN STBartow, FL 33830-5058

Mailing AddressPo Box 1559Bartow, FL 33831-1559 · (863) 519-0575 · Fax (863) 582-9251

Phone(863) 519-0575

Fax(863) 582-9251

Organization SubpartNo

Authorized OfficialJo DeckCredentialing Specialist · (863) 519-0575

Enumeration DateFebruary 24, 2022

Last NPPES UpdateFebruary 13, 20232 updates tracked since enumeration

NPPES CertifiedFebruary 13, 2023

✔ NPI 1174279582 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCase ManagementAgencies

Taxonomy Code251B00000X

Definition

An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access to needed medical, social, educational, and/or other services. Case management services may be used to locate, coordinate, and monitor necessary appropriate services. It may be used to encourage the use of cost-effective medical care by referrals to appropriate providers and to discourage over utilization of costly services. Case management may also serve to provide necessary coordination of non-medical services such as vocational rehabilitation, education, employment, when the services provided enable the individual to function at the highest level.

1239 E MAIN ST, Bartow, FL 33830

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Other Names 1

Doing Business AsPeace River Center

Other Identifiers 1

Medicaid060310430FL

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2152672

Peace River Center · Sebring, FL

Active · expires Aug 13, 2028

CLIA Number10D2152672

Laboratory TypeBehavioral Health Care

Certificate Effective DateAugust 14, 2026

Certificate Expiration DateAugust 13, 2028

Laboratory DirectorMignin P. Burr

Laboratory Phone(863) 519-0575

Laboratory LocationPeace River Center3201 Medical Way Suite 104, Sebring, FL 33870

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KIMBERLY MANGUS

Registered Nurse