River City Mental Health Counseling, Llc | |
4711 Us Highway 17 Ste 4 Fleming Island FL 32003-8211 | |
(904) 465-1275 | |
(904) 485-8359 |
Full Name | River City Mental Health Counseling, Llc |
---|---|
Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 4711 Us Highway 17 Ste 4, Fleming Island, Florida |
Authorized Official Name and Position | Michael Brent Wade (OWNER) |
Authorized Official Contact | 9044651275 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
River City Mental Health Counseling, Llc 308 Marisco Way Jacksonville FL 32220-4608 Ph: (904) 465-1275 | River City Mental Health Counseling, Llc 4711 Us Highway 17 Ste 4 Fleming Island FL 32003-8211 Ph: (904) 465-1275 |
NPI Number | 1518513506 |
---|---|
Provider Enumeration Date | 08/15/2019 |
Last Update Date | 08/15/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1518513506 | NPI | - | NPPES |
007650300 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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