Healthcare Provider Details

I. General information

NPI: 1417867854
Provider Name (Legal Business Name): D&K WELLNESS AND BEHAVIORAL HEALTH SERVICES, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4107 MONCRIEF RD
JACKSONVILLE FL
32209-3935
US

IV. Provider business mailing address

4107 MONCRIEF RD
JACKSONVILLE FL
32209-3935
US

V. Phone/Fax

Practice location:
  • Phone: 904-707-0533
  • Fax:
Mailing address:
  • Phone: 904-707-0533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. SAMANTHA PATTERSON
Title or Position: BILLING MANAGER
Credential:
Phone: 904-719-4013