Organization Active NPI

Baycare Behavioral Health Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Brooksville, FL
National Provider Identifier
1003190323
Registry record updated Feb 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
BAYCARE BEHAVIORAL HEALTH INC.
Practice address
15311 Cortez Blvd
Brooksville, FL 34613-6005
Phone
(752) 540-9335
NPI assigned
Oct 5, 2011
Last updated
Feb 12, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Lynda Gorken
Title
Vice President
Phone
(727) 281-9390

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X FL Primary

Addresses

Primary practice location

15311 Cortez Blvd
Brooksville, FL 34613-6005

Mailing address

2995 Drew St FL 2
Clearwater, FL 33759-3012
Phone (727) 281-9390

Other identifiers 1

IdentifierTypeStateIssuer
060297311MedicaidFL

Other names 1

  • Age 0-20 only Other name

National Provider Directory

National Provider Directory
Tax ID family
The Harbor B H C I28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1317772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581465600000",
    "number": "1003190323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 DREW ST FL 2",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337593012",
            "telephone_number": "727-281-9390",
            "fax_number": "813-635-2613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15311 CORTEZ BLVD",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346136005",
            "telephone_number": "752-540-9335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYCARE BEHAVIORAL HEALTH INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-05",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A",
        "authorized_official_last_name": "GORKEN",
        "authorized_official_first_name": "LYNDA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "727-281-9390",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060297311",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Age 0-20 only",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Age 0-20 only",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Brooksville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.