Organization
MENTAL HEALTH RESOURCE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT SOMMERS PH.D. (PRESIDENT/CEO)
(904) 743-1883
Entity
Organization
Contact information
Practice address
11820 BEACH BLVD, JACKSONVILLE, FL 32246-6670
(904) 642-9100
(904) 642-9108
Mailing address
PO BOX 19249, JACKSONVILLE, FL 32245-9249
(904) 743-1883
(904) 743-5109
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QC1500X
Community Health Clinic/Center
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
273R00000X
Psychiatric Hospital Unit
—
—
283Q00000X
Psychiatric Hospital
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060293100
—
FL
05
—
060293102
—
FL
05
—
060293105
—
FL
05
—
060293106
—
FL
05
—
060293111
—
FL
05
—
060293112
—
FL
05
—
060293113
—
FL
05
—
060293114
—
FL
05
—
261464200
—
FL
01
—
99464
MEDICARE PART B ONLY
FL
Enumeration date
08/21/2006
Last updated
12/15/2022
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