| Gracepoint | |
|
2212 A-b E- Henry Ave Tampa FL 33610-4350 | |
| (813) 272-2878 | |
| (813) 272-3766 |
| Full Name | Gracepoint |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2212 A-b E- Henry Ave, Tampa, Florida |
| Authorized Official Name and Position | Joseph F Rutherford (CEO) |
| Authorized Official Contact | 8132398069 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gracepoint 5707- N. 22nd Street Tampa FL 33610-4350 Ph: (813) 239-8069 | Gracepoint 2212 A-b E- Henry Ave Tampa FL 33610-4350 Ph: (813) 272-2878 |
| NPI Number | 1184833311 |
|---|---|
| Provider Enumeration Date | 05/22/2007 |
| Last Update Date | 07/20/2021 |
| Certification Date | 07/20/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184833311 | NPI | - | NPPES |
| 060272800 | Medicaid | FL | |
| E8E | Other | FL | NEW DIRECTIONS |
| 060272814 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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