Organization
FIRST COAST COMMUNITY SUPPORT SERVICES
Active
Parent organization
FIRST COAST COMMUNITY SUPPORT SERVICES
Organization subpart
Yes
Provider details
NPI number
Legal business name
FIRST COAST COMMUNITY SUPPORT SERVICES
Authorized official
DENISE BOYD MS (ADMINISTRATOR)
(904) 738-8579
Entity
Organization
Contact information
Practice address
5300 SAN JUAN AVE, JACKSONVILLE, FL 32210-3142
(904) 738-8579
(904) 619-7835
Mailing address
5300 SAN JUAN AVE, JACKSONVILLE, FL 32210-3142
(904) 738-8579
(904) 619-7835
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103272401
—
FL
Enumeration date
07/13/2021
Last updated
07/13/2021
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