Healthcare Provider Details

I. General information

NPI: 1215885934
Provider Name (Legal Business Name): JACKSONVILLE BH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2026
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 MOON BAY PKWY
ST AUGUSTINE FL
32095-0182
US

IV. Provider business mailing address

4020 ASPEN GROVE DR STE 900
FRANKLIN TN
37067-3134
US

V. Phone/Fax

Practice location:
  • Phone: 904-869-3100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number StateNULL

VIII. Authorized Official

Name: BRIAN FARLEY
Title or Position: EVP & SECRETARY
Credential:
Phone: 615-861-6000