Organization
NORTHSIDE MENTAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELAINE CHURTON (ASSOCIATE DIRECTOR)
(813) 977-8700
Entity
Organization
Contact information
Practice address
12512 BRUCE B DOWNS BLVD, TAMPA, FL 33612-9209
(813) 977-8700
(813) 975-8138
Mailing address
12512 BRUCE B DOWNS BLVD, TAMPA, FL 33612-9209
(813) 977-8700
(813) 975-8138
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
07/18/2012
Last updated
07/18/2012
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