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General NPI Number Information
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NPI Number | 1770884686
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Entity Type | Organization
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Legal Business Name | YOUTH CRISIS CENTER, INC.
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Dates
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Enumeration Date | 11/09/2010
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Last Update Date | 11/09/2010
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Provider Practice Location Address
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Address Line | 3015 PARENTAL HOME RD
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City | JACKSONVILLE
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State | FL
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Zip | 32216-5704
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Country | US
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Telephone | 904-720-0002
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Fax | 904-724-8513
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Provider Business Mailing Address
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Address Line | 3015 PARENTAL HOME RD
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City | JACKSONVILLE
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State | FL
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Zip | 32216-5704
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Country | US
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Telephone | 904-720-0002
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Fax | 904-724-8513
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. GREGORY STEELE
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Credential | MBA
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Telephone | 904-720-0002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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