Organization
TBD ACQUISITION II LLC
Active
Other names
Gulfport Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE FILTON (CFO SR VP)
(610) 768-3482
Entity
Organization
Contact information
Practice address
1340 BROAD AVE, GULFPORT, MS 39501-2404
(228) 867-5202
Mailing address
11150 HIGHWAY 49, GULFPORT, MS 39503-4110
(228) 867-5202
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
01/03/2018
Last updated
01/03/2018
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