Full Name | Hope Haven |
---|---|
Speciality | Counselor - Mental Health |
Location | 4600 Beach Blvd., Jacksonville, Florida |
Authorized Official Name and Position | Stella Johnson (CHIEF EXECUTIVE OFFICE) |
Authorized Official Contact | 9043465100 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Hope Haven 4600 Beach Blvd. Jacksonville FL 32207 Ph: (904) 346-5100 | Hope Haven 4600 Beach Blvd. Jacksonville FL 32207 Ph: (904) 346-5100 |
NPI Number | 1295769602 |
---|---|
Provider Enumeration Date | 07/10/2006 |
Last Update Date | 08/09/2021 |
Certification Date | 08/09/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1295769602 | NPI | - | NPPES |
060135700 | Medicaid | FL | |
887343700 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
103T00000X | Psychologist | (* (Not Available)) | Secondary |
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