Basic Information
| Provider Information | |||||||||
| NPI: | 1316248891 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BAYCARE BEHAVIORAL HEALTH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14527 7TH ST | ||||||||
| Address2: | |||||||||
| City: | DADE CITY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 335233102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3525211474 | ||||||||
| FaxNumber: | 3525676991 | ||||||||
| Practice Location | |||||||||
| Address1: | 14527 7TH ST | ||||||||
| Address2: | |||||||||
| City: | DADE CITY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 335233102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3525211474 | ||||||||
| FaxNumber: | 3525676991 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2010 | ||||||||
| LastUpdateDate: | 11/15/2010 | ||||||||
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| AuthorizedOfficialLastName: | CAMPBELL | ||||||||
| AuthorizedOfficialFirstName: | STEPHANIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CASE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 3525211475 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | B.A. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 273R00000X | 171M00000X | FL | Y | Hospital Units | Psychiatric Unit |
No ID Information.