Healthcare Provider Details

I. General information

NPI: 1851218523
Provider Name (Legal Business Name): TEN BROECK TAMPA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29910 SR-56
WESLEY CHAPEL FL
33543
US

IV. Provider business mailing address

4020 ASPEN GROVE DR STE 900
FRANKLIN TN
37067-3134
US

V. Phone/Fax

Practice location:
  • Phone: 813-795-0514
  • Fax:
Mailing address:
  • Phone: 615-861-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: BRIAN FARLEY
Title or Position: VICE PRESIDENT & SECRETARY
Credential:
Phone: 615-861-6000