Organization
TRIDENT BEHAVIORAL HEALTHCARE, INC.
Active
Organization
TRIDENT BEHAVIORAL HEALTHCARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THEODORE KENNETH FERGUSON II (PRESIDENT)
(352) 232-0839
Entity
Organization
Contact information
Practice address
6133 US HIGHWAY 19, NEW PORT RICHEY, FL 34652-2527
(727) 842-6900
(727) 842-6902
Mailing address
6131 US HIGHWAY 19, NEW PORT RICHEY, FL 34652-2527
(727) 842-6900
(727) 842-6902
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
09/18/2012
Last updated
09/18/2012
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