| North Florida Health Center, Inc. | |
|
1373 Ohio Ave North Live Oak FL 32064 | |
| (386) 590-7096 | |
| Not Available |
| Full Name | North Florida Health Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1373 Ohio Ave North, Live Oak, Florida |
| Authorized Official Name and Position | Jennifer Lacasse (CEO) |
| Authorized Official Contact | 3865907096 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Florida Health Center, Inc. 1372 Ohio Ave North Live Oak FL 32064 Ph: (386) 590-7096 | North Florida Health Center, Inc. 1373 Ohio Ave North Live Oak FL 32064 Ph: (386) 590-7096 |
| NPI Number | 1093593709 |
|---|---|
| Provider Enumeration Date | 09/15/2023 |
| Last Update Date | 10/06/2023 |
| Certification Date | 10/05/2023 |
| Medicare PECOS PAC ID | 5294187548 |
|---|---|
| Medicare Enrollment ID | O20240123000512 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093593709 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Jennifer L Lacasse |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194178814 PECOS PAC ID: 2769715127 Enrollment ID: I20190618000550 |
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