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NPI Code Detail

MEDICARE: CLAY BEHAVIORAL HEALTH CENTER, INC.

MEDICARE: CLAY BEHAVIORAL HEALTH CENTER, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251B00000XCase Management Agency0410AD931700FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720089782
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLAY BEHAVIORAL HEALTH CENTER, INC.
Provider Business Mailing Address
First Line : 41 KNIGHT BOXX RD
Second Line :
City : ORANGE PARK
State : FL
Zip : 32065-7305
Country : US
Telephone Number : 904-385-2135
Fax Number :
Provider Business Practice Location Address
First Line : 3292 COUNTY ROAD 220
Second Line :
City : MIDDLEBURG
State : FL
Zip : 32068-4357
Country : US
Telephone Number : 904-291-5561
Fax Number : 904-291-5575
Authorized Official
Title or Position : DIRECTOR OF FINANCE
Name : MS. TINA MARIE SWATHWOOD
Credential :
Telephone Number : 904-278-5645
Provider Enumeration Date : 08/02/2005
Last Update Date : 03/20/2025

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Directions to “CLAY BEHAVIORAL HEALTH CENTER, INC. ” Practice Location

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