Healthcare Provider Details

I. General information

NPI: 1710896204
Provider Name (Legal Business Name): CLAY BEHAVIORAL HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 KNIGHT BOXX RD STE 2
ORANGE PARK FL
32065-7305
US

IV. Provider business mailing address

41 KNIGHT BOXX RD
ORANGE PARK FL
32065-7305
US

V. Phone/Fax

Practice location:
  • Phone: 904-728-5379
  • Fax: 904-291-5575
Mailing address:
  • Phone: 907-385-2135
  • Fax: 904-291-5575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: IRENE M TOTO
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: LMHC
Phone: 904-385-2135