Organization
NORTHWEST BEHAVIORAL HEALTH SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERRI D GLOVER MA (EXECUTIVE DIRECTOR, CEO)
(904) 781-0600
Entity
Organization
Contact information
Practice address
2392 EDGEWOOD AVE N, JACKSONVILLE, FL 32254-1725
(904) 781-7797
(904) 781-8685
Mailing address
2392 EDGEWOOD AVE N, JACKSONVILLE, FL 32254-1725
(904) 781-0600
(904) 781-8685
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
FL
251C00000X
Developmentally Disabled Services Day Training Agency
—
FL
251S00000X
Community/Behavioral Health Agency
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029591400
—
FL
05
—
029591401
—
FL
01
—
284275
HMO
FL
05
—
681396800
—
FL
Enumeration date
07/14/2005
Last updated
11/07/2023
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