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General NPI Number Information
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NPI Number | 1164485074
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Entity Type | Organization
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Legal Business Name | TRI COUNTY HUMAN SERVICES, INC.
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Dates
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Enumeration Date | 04/11/2006
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 2340 COMMERCE POINT DR
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City | LAKELAND
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State | FL
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Zip | 33801-6880
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Country | US
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Telephone | 863-709-8543
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Fax |
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Provider Business Mailing Address
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Address Line | 2026 CRYSTAL WOOD DR
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City | LAKELAND
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State | FL
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Zip | 33801-6884
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Country | US
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Telephone | 863-709-9392
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Fax | 863-709-8923
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Authorized Official
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Title or Position | ADMIN DIRECTOR
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Name | BECKY RAZAIRE
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Credential |
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Telephone | 863-899-9538
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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