Organization
BAPTIST BEHAVIORAL HEALTH, LLC
Active
Parent organization
BAPTIST BEHAVIORAL HEALTH, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BAPTIST BEHAVIORAL HEALTH, LLC
Authorized official
ELIZABETH TISH DE MEDICI (CREDENTIALING MGR)
(904) 376-3800
Entity
Organization
Contact information
Practice address
1650 PRUDENTIAL DR STE 210, JACKSONVILLE, FL 32207-8149
(904) 376-3800
(904) 376-3998
Mailing address
PO BOX 748519, ATLANTA, GA 30374-8519
(904) 376-3800
(904) 376-3998
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
07/08/2022
Last updated
07/08/2022
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