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8787 Bryan Dairy Rd Ste 275 Largo FL 33777-1260 | |
| (727) 457-5614 | |
| (813) 635-2613 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 8787 Bryan Dairy Rd Ste 275, Largo, Florida |
| Authorized Official Name and Position | Lynda Gorken (VICE PRESIDENT) |
| Authorized Official Contact | 7272819390 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2995 Drew St Fl 2 Clearwater FL 33759-3012 Ph: (727) 281-9390 | 8787 Bryan Dairy Rd Ste 275 Largo FL 33777-1260 Ph: (727) 457-5614 |
| NPI Number | 1164788154 |
|---|---|
| Provider Enumeration Date | 04/04/2012 |
| Last Update Date | 05/21/2024 |
| Certification Date | 05/21/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164788154 | NPI | - | NPPES |
| 060297338 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Reachout4 Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 13785 Walsingham Rd, #440, Largo, FL 33774 Phone: 727-641-8878 | |
Creative Behavior Solutions, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 12505 Starkey Rd Ste K, Largo, FL 33773 Phone: 727-280-6643 | |
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Deborah Bloome, Psy.d. Pa Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 14521 Walsingham Rd, Largo, FL 33774 Phone: 727-517-1938 |