MEDICARE: COMMUNITY HEALTH INITIATIVES GROUP, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QC1500X	Community Health Clinic/Center
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
3	3336C0002X	Clinic Pharmacy
4	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1215735808
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY HEALTH INITIATIVES GROUP, INC.

Provider Business Mailing Address
First Line	:	8411 SOUTHSIDE BLVD STE 100
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-0755
Country	:	US
Telephone Number	:	904-323-4488
Fax Number	:	904-323-4488

Provider Business Practice Location Address
First Line	:	934 ARLINGTON RD N
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32211-5956
Country	:	US
Telephone Number	:	904-323-4488
Fax Number	:	904-323-4488

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JASON MOUNT
Credential	:
Telephone Number	:	904-699-2332

Provider Enumeration Date	:	03/07/2025
Last Update Date	:	03/07/2025

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