Provider Demographics
NPI:1013524883
Name:TRUECANDOR BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:TRUECANDOR BEHAVIORAL HEALTH, LLC
Other - Org Name:BEGIN AGAIN COUNSELING SERVICES, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORBETT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:813-419-3386
Mailing Address - Street 1:1202 FLORABLU DR
Mailing Address - Street 2:
Mailing Address - City:SEFFNER
Mailing Address - State:FL
Mailing Address - Zip Code:33584-3531
Mailing Address - Country:US
Mailing Address - Phone:813-419-3386
Mailing Address - Fax:813-793-4879
Practice Address - Street 1:6338 US HIGHWAY 301 S
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-3829
Practice Address - Country:US
Practice Address - Phone:813-419-3386
Practice Address - Fax:813-793-4879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-25
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1134565245Medicaid