Organization
MENTAL HEALTH CENTER OF JACKSONVILLE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT SOMMERS PH.D. (PRESIDENT AND CEO)
(904) 743-1883
Entity
Organization
Contact information
Practice address
3333 W 20TH ST, JACKSONVILLE, FL 32254-1703
(904) 695-9145
(904) 695-2465
Mailing address
PO BOX 19189, JACKSONVILLE, FL 32245-9189
(904) 743-1883
(904) 743-5109
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261QC1500X
Community Health Clinic/Center
Primary
—
—
283Q00000X
Psychiatric Hospital
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060366000
—
FL
05
—
060366002
—
FL
Enumeration date
08/22/2006
Last updated
01/26/2015
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