Healthcare Provider Details

I. General information

NPI: 1861264418
Provider Name (Legal Business Name): JEWISH FAMILY AND COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2023
Last Update Date: 10/26/2023
Certification Date: 10/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8540 BAYCENTER RD
JACKSONVILLE FL
32256-7420
US

IV. Provider business mailing address

8540 BAYCENTER RD
JACKSONVILLE FL
32256-7420
US

V. Phone/Fax

Practice location:
  • Phone: 904-448-1933
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: COLLEEN LLOYD RODRIGUEZ
Title or Position: EXECUTIVE DIRECTOR
Credential: LCSW
Phone: 904-759-8222