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NPI 1558325050

NPI 1558325050 : NASSAU COUNTY MENTAL HEALTH ALCOHOL & DRUG ABUSE COUNCIL INC : YULEE, FL

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General NPI Number Information
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    NPI Number           |    1558325050
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    Entity Type          |    Organization 
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    Legal Business Name  |    NASSAU COUNTY MENTAL HEALTH ALCOHOL & DRUG ABUSE COUNCIL INC 
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Dates
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    Enumeration Date     |    04/13/2006
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    Last Update Date     |    10/26/2022
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Provider Practice Location 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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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                  |    904-225-8832
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Authorized Official
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    Title or Position    |    HR 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        |    251V00000X
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    Taxonomy Name        |    Voluntary or Charitable Agency
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    License Number       |    550400709285C
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    License Number State |    FL
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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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