Organization
NORTHSIDE BEHAVIORAL HEALTH CENTER, INC.
Active
Other names
NORTHSIDE BEHAVIORAL HEALTH CENTER INC
Organization subpart
No
Provider details
NPI number
Authorized official
LYNDA GORKEN (VICE PRESIDENT)
(727) 281-9202
Entity
Organization
Contact information
Practice address
12512 BRUCE B DOWNS BLVD, TAMPA, FL 33612-9209
(813) 977-8700
(813) 971-2029
Mailing address
2995 DREW ST FL 2, CLEARWATER, FL 33759-3012
(727) 315-6974
(813) 635-2613
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117580100
—
FL
Enumeration date
06/22/2012
Last updated
08/01/2023
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