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General NPI Number Information
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NPI Number | 1215735808
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTH INITIATIVES GROUP, INC.
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Dates
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Enumeration Date | 03/07/2025
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 934 ARLINGTON RD N
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City | JACKSONVILLE
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State | FL
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Zip | 32211-5956
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Country | US
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Telephone | 904-323-4488
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Fax | 904-323-4488
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Provider Business Mailing Address
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Address Line | 8411 SOUTHSIDE BLVD STE 100
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City | JACKSONVILLE
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State | FL
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Zip | 32256-0755
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Country | US
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Telephone | 904-323-4488
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Fax | 904-323-4488
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JASON MOUNT
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Credential |
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Telephone | 904-699-2332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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