Organization
ST JOHNS COUNTY BOARD OF COUNTY COMMISSIONERS
Active
Other names
ST JOHNS COUNTY MENTAL HEALTH DEPARTMENT
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA COLAVITO PHD (HEALTH & HUMAN SERVICES DIRECTOR)
(904) 209-6082
Entity
Organization
Contact information
Practice address
1955 US HIGHWAY 1 S, SUITE C-2, ST AUGUSTINE, FL 32086-3708
(904) 209-6001
(904) 209-6002
Mailing address
1955 US HIGHWAY 1 S, SUITE C-2, ST AUGUSTINE, FL 32086-3708
(904) 209-6001
(904) 209-6002
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39301
OUTPATIENT SERVICES
FL
Enumeration date
10/19/2005
Last updated
07/16/2007
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