Healthcare Provider Details

I. General information

NPI: 1710692611
Provider Name (Legal Business Name): BAYCARE BEHAVIORAL HEALTH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2023
Last Update Date: 01/16/2023
Certification Date: 01/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5425 COMMERCIAL WAY
SPRING HILL FL
34606-1110
US

IV. Provider business mailing address

2995 DREW ST FL 2
CLEARWATER FL
33759-3012
US

V. Phone/Fax

Practice location:
  • Phone: 352-540-9335
  • Fax: 352-544-0722
Mailing address:
  • Phone: 727-281-9065
  • Fax: 813-635-2613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: LYNDA GORKEN
Title or Position: VICE PRESIDENT
Credential:
Phone: 727-281-9202