| Child Guidance Center, Inc. | |
|
4595 Lexington Ave Jacksonville FL 32210-2058 | |
| (904) 448-4700 | |
| Not Available |
| Full Name | Child Guidance Center, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4595 Lexington Ave, Jacksonville, Florida |
| Authorized Official Name and Position | Beth Ellen Oberlander (CHIEF CLINICAL OFFICER) |
| Authorized Official Contact | 9044006739 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Child Guidance Center, Inc. 5776 Saint Augustine Rd Jacksonville FL 32207-8046 Ph: (904) 400-6739 | Child Guidance Center, Inc. 4595 Lexington Ave Jacksonville FL 32210-2058 Ph: (904) 448-4700 |
| NPI Number | 1144898974 |
|---|---|
| Provider Enumeration Date | 06/17/2021 |
| Last Update Date | 06/17/2021 |
| Certification Date | 06/17/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144898974 | NPI | - | NPPES |
| 060404606 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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