# NORTHSIDE BEHAVIORAL HEALTH CENTER, INC.

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

## Provider details

- **NPI number:** 1659672715
- **Authorized official:** KRISTINA M HUST LMHC (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (813) 977-8700

## Contact information

- **Practice address:** 12512 BRUCE B DOWNS BLVD, TAMPA, FL 33612-9209
- **Practice address phone:** (813) 977-8700
- **Practice address fax:** (813) 971-2029
- **Mailing address:** 12512 BRUCE B DOWNS BLVD, TAMPA, FL 33612-9209
- **Mailing address phone:** (813) 977-8700
- **Mailing address fax:** (813) 971-2029

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |
| 261Q00000X | Clinic/Center | 8522 | FL | — |

## Other

- **Enumeration date:** 11/05/2010
- **Last updated:** 12/07/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 060370800 | — | FL |
| 05 | — | 060370807 | — | FL |