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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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