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General NPI Number Information
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NPI Number | 1720089782
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Entity Type | Organization
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Legal Business Name | CLAY BEHAVIORAL HEALTH CENTER, INC.
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Dates
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Enumeration Date | 08/02/2005
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 3292 COUNTY ROAD 220
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City | MIDDLEBURG
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State | FL
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Zip | 32068-4357
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Country | US
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Telephone | 904-291-5561
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Fax | 904-291-5575
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Provider Business Mailing Address
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Address Line | 41 KNIGHT BOXX RD
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City | ORANGE PARK
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State | FL
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Zip | 32065-7305
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Country | US
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Telephone | 904-385-2135
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF FINANCE
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Name | MS. TINA MARIE SWATHWOOD
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Credential |
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Telephone | 904-278-5645
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 0410AD931700
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License Number State | FL
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