Organization
HENDRY-GLADES MENTAL HEALTH CLINIC, INC.
Active
Other names
HENDRY-GLADES BEHAVIORAL HEALTH CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH F. HOSICK JR. MPA/CBHE (CEO / CFO)
(863) 983-1423
Entity
Organization
Contact information
Practice address
601 W ALVERDEZ AVE, CLEWISTON, FL 33440-3504
(863) 983-1423
(863) 983-1426
Mailing address
601 W ALVERDEZ AVE, CLEWISTON, FL 33440-3504
(863) 983-1423
(863) 983-1426
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
0822AD8636-00
FL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
0826AD8636-01
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060555700
—
FL
05
—
060555701
—
FL
05
—
060555702
—
FL
05
—
060555703
—
FL
Enumeration date
10/03/2006
Last updated
12/17/2009
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