# JACKSONVILLE BEHAVIOR AND MENTAL HEALTH

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

## Provider details

- **NPI number:** 1770771750
- **Authorized official:** MADHUR MITTAL MD (PRESIDENT)
- **Authorized official phone:** (910) 353-0581

## Contact information

- **Practice address:** 156 MEMORIAL CT, JACKSONVILLE, NC 28546-6322
- **Practice address phone:** (910) 353-0680
- **Practice address fax:** (910) 353-3629
- **Mailing address:** 118 MEMORIAL DR, JACKSONVILLE, NC 28546-6328
- **Mailing address phone:** (910) 353-0581
- **Mailing address fax:** (910) 939-4269

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | 3758 | NC | Yes |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 10/04/2007
- **Last updated:** 07/08/2020