Organization
NORTHWEST BHVRL HLTH SVS,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRICIA SAMPSON (EXECUTIVE DIRECTOR)
(904) 781-7797
Entity
Organization
Contact information
Practice address
2392 EDGEWOOD AVE N, JACKSONVILLE, FL 32254-1725
(904) 781-7797
Mailing address
2392 EDGEWOOD AVE N, JACKSONVILLE, FL 32254-1725
(904) 781-7797
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/18/2007
Last updated
09/09/2008
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