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General NPI Number Information
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NPI Number | 1306184239
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Entity Type | Organization
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Legal Business Name | BAYCARE BEHAVIORAL HEALTH INC.
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Dates
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Enumeration Date | 01/28/2013
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Last Update Date | 02/12/2020
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Provider Practice Location Address
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Address Line | 2461 ENTERPRISE RD SUITE C
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City | CLEARWATER
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State | FL
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Zip | 33763-1726
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Country | US
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Telephone | 727-726-3785
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Fax |
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Provider Business Mailing Address
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Address Line | 2995 DREW ST FL 2
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City | CLEARWATER
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State | FL
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Zip | 33759-3012
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Country | US
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Telephone | 727-281-9390
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Fax | 813-635-2613
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MRS. LYNDA GORKEN
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Credential |
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Telephone | 727-281-9390
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State | FL
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