# JACKSONVILLE BEACH PSYCHIATRIC SERVICE

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

## Provider details

- **NPI number:** 1922543941
- **Authorized official:** KYLE MARCOTTE (OWNER)
- **Authorized official phone:** (954) 746-8232

## Contact information

- **Practice address:** 390 16TH AVE S, JACKSONVILLE, FL 32250-4961
- **Practice address phone:** (954) 746-8232
- **Mailing address:** 390 16TH AVE S, JACKSONVILLE, FL 32250-4961

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/29/2016
- **Last updated:** 01/03/2017