# NORTHSIDE BEHAVIORAL HEALTH CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** NORTHSIDE BEHAVIORAL HEALTH CENTER INC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750644811
- **Authorized official:** LYNDA GORKEN (VICE PRESIDENT)
- **Authorized official phone:** (727) 281-9202

## 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:** 2995 DREW ST FL 2, CLEARWATER, FL 33759-3012
- **Mailing address phone:** (727) 315-6974
- **Mailing address fax:** (813) 635-2613

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 06/22/2012
- **Last updated:** 08/01/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 117580100 | — | FL |