|Taxonomy Code||Specialty Code||Provider Type|
|LBN Legal business name||PBSRE, LLC|
|DBA Doing business as||BLUE HORIZON EATING DISORDER SERVICES|
|Authorized official||STEWART GOLD - (CHIEF LEGAL OFFICER)|
|Organization subpart 1||No|
|Last updated||01/25/2016 - About 9 months ago|
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