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General NPI Number Information
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NPI Number | 1316289333
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Entity Type | Organization
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Legal Business Name | RIVER REGION HUMAN SERVICES
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Dates
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Enumeration Date | 03/18/2013
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Last Update Date | 03/18/2013
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Provider Practice Location Address
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Address Line | 3020 WARRINGTON ST
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City | JACKSONVILLE
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State | FL
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Zip | 32254-3937
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Country | US
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Telephone | 904-899-6300
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Fax |
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Provider Business Mailing Address
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Address Line | 3020 WARRINGTON ST
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City | JACKSONVILLE
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State | FL
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Zip | 32254-3937
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | HEALTH SERVICES INFORMATION
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Name | DEBRA HASKELL
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Credential |
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Telephone | 904-899-6300
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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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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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