| NPI | 1306184239 |
|---|---|
| Other Name | COUNTRYSIDE - PRIMARY CARE |
| Entity Type | Organization |
| Authorized Contact | LYNDA GORKEN Vice President 727-281-9390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2013-01-28 |
| Last Update Date | 2020-02-12 |