Organization
BRING YOUR BROKENNESS INC
Active
Other names
The Charis House, Bring Your Brokenness Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMIE N. SHIELDS (CEO)
(904) 789-4673
Entity
Organization
Contact information
Practice address
87616 ROSES BLUFF RD, YULEE, FL 32097-4998
(904) 789-4673
Mailing address
87616 ROSES BLUFF RD, YULEE, FL 32097-4998
(904) 789-4673
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8742
AHCA LICENSE
FL
Enumeration date
08/03/2022
Last updated
01/08/2024
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