Organization
CHILDREN'S HOME SOCIETY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA POOLE LMHC (CLINICAL DIRECTOR)
(904) 238-3638
Entity
Organization
Contact information
Practice address
3027 SAN DIEGO RD, JACKSONVILLE, FL 32207-3691
(904) 493-7743
Mailing address
3027 SAN DIEGO RD, JACKSONVILLE, FL 32207-3691
(904) 493-7743
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/21/2011
Last updated
09/21/2011
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