Provider Demographics
NPI:1043357890
Name:BAY AREA BEHAVIORAL SERVICES
Entity type:Organization
Organization Name:BAY AREA BEHAVIORAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:GLENN
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:813-689-8828
Mailing Address - Street 1:135 N MOON AVE
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33510-4419
Mailing Address - Country:US
Mailing Address - Phone:813-689-8828
Mailing Address - Fax:813-689-8802
Practice Address - Street 1:13575 58TH ST N
Practice Address - Street 2:SUITE 131
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33760-3740
Practice Address - Country:US
Practice Address - Phone:813-689-8828
Practice Address - Fax:813-689-8802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty