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General NPI Number Information
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NPI Number | 1194470567
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Entity Type | Organization
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Legal Business Name | NASSAU COUNTY MENTAL HEALTH ALCOHOL & DRUG ABUSE
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Dates
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Enumeration Date | 02/15/2022
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 2201 SADLER RD
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City | FERNANDINA BEACH
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State | FL
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Zip | 32034-4558
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Country | US
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Telephone | 904-225-8280
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Fax |
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Provider Business Mailing Address
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Address Line | 463142 STATE ROAD 200
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City | YULEE
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State | FL
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Zip | 32097-5554
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Country | US
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Telephone | 904-225-8280
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Fax | 904-225-8232
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Authorized Official
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Title or Position | HUMAN RESOURCES GENERALIST
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Name | BRENDA HICKOX
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Credential |
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Telephone | 904-225-8280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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