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General NPI Number Information
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NPI Number | 1164300117
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Entity Type | Organization
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Legal Business Name | GRATITUDE BEHAVIORAL HEALTH AND WELLNESS PA
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Dates
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Enumeration Date | 08/26/2025
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 5656 BAYWATER DR
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City | TAMPA
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State | FL
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Zip | 33615-3501
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Country | US
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Telephone | 813-435-9965
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Fax | 813-212-5229
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Provider Business Mailing Address
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Address Line | 8635 W HILLSBOROUGH AVE # 316
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City | TAMPA
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State | FL
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Zip | 33615-3810
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Country | US
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Telephone | 813-435-9965
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Fax | 813-212-5229
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Authorized Official
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Title or Position | OWNER
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Name | SARAH J HORDEYCZUK
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Credential | APRN
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Telephone | 813-435-9965
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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