Organization
DIVERSE BEHAVIORAL SERVICES CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAYELIN SANTOS (OWNER)
(813) 610-3262
Entity
Organization
Contact information
Practice address
4504 WISHART PL, TAMPA, FL 33603-2724
(813) 610-3262
Mailing address
4504 WISHART PL, TAMPA, FL 33603-2724
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
08/29/2022
Last updated
08/29/2022
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