Organization
LUCID STAR HEALTHCARE OF FLORIDA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS TOBEY (DIRECTOR)
(904) 534-8814
Entity
Organization
Contact information
Practice address
841 PRUDENTIAL DR, 12TH. FLOOR, JACKSONVILLE, FL 32207-8329
(877) 296-2293
Mailing address
841 PRUDENTIAL DR, 12TH. FLOOR, JACKSONVILLE, FL 32207-8329
(877) 296-2293
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007140900
—
FL
Enumeration date
03/16/2015
Last updated
03/16/2015
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