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FQHCLA430 MENTAL HEALTH CARE, INC. (Active)
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Main Details
Name
MENTAL HEALTH CARE, INC.
Subdivision Name
Gracepoint Wellness Clinic
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-032216
340B ID
FQHCLA430
Grant Number
LALCS40297
Additional Details
Current Program Status
Active
Registration Date
10/1/2021
Participating Start Date
1/1/2022
Participating Approval Date
10/5/2021
Last Recertification Date
2/13/2025
Contacts
Authorizing Official
Gracepoint
Roaya Tyson, CEO
(813) 965-2630
Primary Contact
Mental Health Care dba Gracepoint
Joe Lallanilla, Chief Operating Officer
(813) 317-4648
Addresses
Street Address
5707 N. 22nd Street
Tampa, FL 33610-4350
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
April 2025
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