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Organization
NORTHSIDE BEHAVIORAL HEALTH CENTER, INC.
Active
Organization
NORTHSIDE BEHAVIORAL HEALTH CENTER, INC.
Active
Other names
NORTHSIDE BEHAVIORAL HEALTH CENTER INC
Organization subpart
No
Provider details
NPI number
Authorized official
LYNDA GORKEN (VICE PRESIDENT)
(727) 281-9202
Entity
Organization
Contact information
Practice address
12512 BRUCE B DOWNS BLVD, TAMPA, FL 33612-9209
(813) 977-8700
(813) 971-2029
Mailing address
2995 DREW ST FL 2, CLEARWATER, FL 33759-3012
(727) 315-6974
(813) 635-2613
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117580100
—
FL
Enumeration date
06/22/2012
Last updated
08/01/2023
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