Provider Demographics
NPI:1508403965
Name:INSIGHT BEHAVIORAL HEALTH & ADDICTION SOLUTIONS, INC.
Entity Type:Organization
Organization Name:INSIGHT BEHAVIORAL HEALTH & ADDICTION SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SUNDHOLM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-330-2532
Mailing Address - Street 1:508 W FLETCHER AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-3413
Mailing Address - Country:US
Mailing Address - Phone:888-330-2532
Mailing Address - Fax:
Practice Address - Street 1:9270 ROYAL PALM AVE
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34654-5018
Practice Address - Country:US
Practice Address - Phone:888-330-2532
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-04
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility