Healthcare Provider Details

I. General information

NPI: 1013524883
Provider Name (Legal Business Name): TRUECANDOR BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2020
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6320 US HIGHWAY 301 S
RIVERVIEW FL
33578-3829
US

IV. Provider business mailing address

1202 FLORABLU DR
SEFFNER FL
33584-3531
US

V. Phone/Fax

Practice location:
  • Phone: 813-419-3386
  • Fax: 813-793-4879
Mailing address:
  • Phone: 813-419-3386
  • Fax: 813-793-4879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ANGELA CORBETT
Title or Position: OWNER
Credential: LCSW
Phone: 813-419-3386