Provider Demographics
NPI:1295367522
Name:HELP CENTER JACKSONVILLE, LLC
Entity Type:Organization
Organization Name:HELP CENTER JACKSONVILLE, LLC
Other - Org Name:HELP CENTER JACKSONVILLE
Other - Org Type:Other Name
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:SHONSIERAE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-386-8575
Mailing Address - Street 1:4651 SALISBURY RD STE 400
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-6187
Mailing Address - Country:US
Mailing Address - Phone:904-386-8575
Mailing Address - Fax:904-900-1140
Practice Address - Street 1:9471 BAYMEADOWS RD STE 104
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-7919
Practice Address - Country:US
Practice Address - Phone:904-386-8575
Practice Address - Fax:904-900-1140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-05
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty