Organization
THRIVE BEHAVIORAL SCIENCES TAMPA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOLENE DE LA GARDELLE (VP - OPERATIONS)
(813) 277-4571
Entity
Organization
Contact information
Practice address
5510 N HESPERIDES ST, TAMPA, FL 33614-5414
(813) 467-6111
(813) 467-6013
Mailing address
5510 N HESPERIDES ST, TAMPA, FL 33614-5414
(813) 277-4571
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0805X
Geriatric Psychiatry Physician
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
07/24/2018
Last updated
09/04/2024
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