Organization
CHILD GUIDANCE CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETH ELLEN OBERLANDER (CHIEF CLINICAL OFFICER)
(904) 400-6739
Entity
Organization
Contact information
Practice address
5776 SAINT AUGUSTINE RD, JACKSONVILLE, FL 32207-8030
(904) 448-4700
(904) 448-4717
Mailing address
5776 SAINT AUGUSTINE RD, JACKSONVILLE, FL 32207-8030
(904) 448-4700
(904) 448-4717
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060404600
—
FL
05
—
060404613
—
FL
Enumeration date
07/25/2006
Last updated
06/17/2021
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