MEDICARE: MENTAL HEALTH CARE, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)		FL
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336358555
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MENTAL HEALTH CARE, INC

Provider Business Mailing Address
First Line	:	5707 N 22ND STREET
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33610-4300
Country	:	US
Telephone Number	:	813-239-8069
Fax Number	:	813-231-7324

Provider Business Practice Location Address
First Line	:	2208 E. HENRY AVENUE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33610-4300
Country	:	US
Telephone Number	:	813-272-2878
Fax Number	:	813-231-7324

Authorized Official
Title or Position	:	CEO
Name	:	MRS. ROAYA TYSON
Credential	:
Telephone Number	:	813-239-8069

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	09/06/2022

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Directions to “MENTAL HEALTH CARE, INC ” Practice Location

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