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Organization

NEW HEAVEN DOMINION, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BRIAN ARTHUR GEORGE (EXECUTIVE DIRECTOR)
(904) 790-0721
Entity
Organization

Contact information

Practice address
9146 RIDGE BRIER LN, JACKSONVILLE, FL 32225-9325
(904) 647-6651
(904) 647-6653
Mailing address
12355 FINNS COVE TRL, JACKSONVILLE, FL 32246-4198
(904) 790-0721
(904) 619-6025

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
02084206
FL

Other

Enumeration date
09/08/2008
Last updated
09/12/2008
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