Provider Demographics
NPI:1558325050
Name:NASSAU COUNTY MENTAL HEALTH ALCOHOL & DRUG ABUSE COUNCIL INC
Entity Type:Organization
Organization Name:NASSAU COUNTY MENTAL HEALTH ALCOHOL & DRUG ABUSE COUNCIL INC
Other - Org Name:STARTING POINT BEHAVIORAL HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HR GENERALIST
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HICKOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-225-8280
Mailing Address - Street 1:463142 STATE ROAD 200
Mailing Address - Street 2:
Mailing Address - City:YULEE
Mailing Address - State:FL
Mailing Address - Zip Code:32097-5554
Mailing Address - Country:US
Mailing Address - Phone:904-225-8280
Mailing Address - Fax:904-225-8832
Practice Address - Street 1:463142 STATE ROAD 200
Practice Address - Street 2:
Practice Address - City:YULEE
Practice Address - State:FL
Practice Address - Zip Code:32097-5554
Practice Address - Country:US
Practice Address - Phone:904-225-8280
Practice Address - Fax:904-225-8232
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NASSAU COUNTY MENTAL HEALTH ALCOHOL & DRUG ABUSE COUNCIL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-13
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL550400709285C251V00000X
261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL029593100Medicaid
FL000000000078262OtherBCBS
FL029531000Medicaid
FL6160AMedicare ID - Type Unspecified
FL029593100Medicaid
FL000000000078262OtherBCBS
FL029531000Medicaid