Organization
NORTHSIDE BEHAVIORAL HEALTH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINA M HUST LMHC (DIRECTOR OF OPERATIONS)
(813) 977-8700
Entity
Organization
Contact information
Practice address
12512 BRUCE B DOWNS BLVD, TAMPA, FL 33612-9209
(813) 977-8700
(813) 971-2029
Mailing address
12512 BRUCE B DOWNS BLVD, TAMPA, FL 33612-9209
(813) 977-8700
(813) 971-2029
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
261Q00000X
Clinic/Center
8522
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060370800
—
FL
05
—
060370807
—
FL
Enumeration date
11/05/2010
Last updated
12/07/2021
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