# GRACEPOINT MHC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225465073
- **Authorized official:** KEITH WATERS (CLINICAL CASE MANAGER)
- **Authorized official phone:** (813) 239-8331

## Contact information

- **Practice address:** 5707 N 22ND ST, TAMPA, FL 33610-4350
- **Practice address phone:** (813) 239-8331
- **Mailing address:** 5707 N 22ND ST, TAMPA, FL 33610-4350
- **Mailing address phone:** (813) 239-8331

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | X. | FL | Yes |

## Other

- **Enumeration date:** 10/10/2013
- **Last updated:** 07/21/2022