Organization
NORTHEAST FLORIDA HEALTH SERVICES, INC.
Active
Other names
Family Health Source
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA COLLIER (CREDENTIALING SPECIALIST)
(386) 202-6025
Entity
Organization
Contact information
Practice address
801 BEVILLE RD STE 103, SOUTH DAYTONA, FL 32119-1861
(386) 267-6214
Mailing address
1205 S WOODLAND BLVD, DELAND, FL 32720-7466
(386) 202-6025
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
09/01/2017
Last updated
05/06/2021
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