Organization
YKKAEB COMMUNITY CARE CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA MITCHELL B.A., CBHCM (CEO)
(904) 203-9258
Entity
Organization
Contact information
Practice address
13245 ATLANTIC BLVD # 205, JACKSONVILLE, FL 32225-7121
(904) 203-9258
Mailing address
13245 ATLANTIC BLVD # 205, JACKSONVILLE, FL 32225-7121
(904) 203-9258
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235553538
—
FL
Enumeration date
06/14/2022
Last updated
06/14/2022
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