| NPI | 1669498002 |
|---|---|
| Former Legal Business Name | NORTHSIDE MENTAL HEALTH CTR, INC |
| Entity Type | Organization |
| Authorized Contact | LYNDA GORKEN Vice President 727-281-9202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2023-08-01 |