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6300 Beach Blvd Jacksonville FL 32216-2708 | |
| (904) 724-9202 | |
| (904) 306-0877 |
| Full Name | |
|---|---|
| Speciality | Psychiatric Hospital |
| Location | 6300 Beach Blvd, Jacksonville, Florida |
| Authorized Official Name and Position | Steve Filton (SR VP & CEO) |
| Authorized Official Contact | 6107683300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
6300 Beach Blvd Jacksonville FL 32216-2708 Ph: (904) 724-9202 | 6300 Beach Blvd Jacksonville FL 32216-2708 Ph: (904) 724-9202 |
| NPI Number | 1568633683 |
|---|---|
| Provider Enumeration Date | 03/17/2008 |
| Last Update Date | 07/02/2024 |
| Certification Date | 07/02/2024 |
| Medicare PECOS PAC ID | 4981789823 |
|---|---|
| Medicare Enrollment ID | O20080701000181 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568633683 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 283Q00000X | Psychiatric Hospital | (Florida) | Primary |
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