# NORTH WEST BEHAVIORIAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720522915
- **Authorized official:** CHARLES DAVID TIMMONS B.A. (CASE MANAGER)
- **Authorized official phone:** (904) 781-7797

## Contact information

- **Practice address:** 2392 EDGEWOOD AVE N, JACKSONVILLE, FL 32254-1725
- **Practice address phone:** (904) 781-7797
- **Mailing address:** 2392 EDGEWOOD AVE N, JACKSONVILLE, FL 32254-1725
- **Mailing address phone:** (904) 781-7797

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 12/07/2016
- **Last updated:** 12/07/2016