NPI 1528165909

Community Rehabilitation Center INC

Organisation Point of Service Jacksonville, FL

Practice location

Address: 623 Beechwood Strret, Jacksonville, FL 32206
Phone: (904) 358-1211
Fax: (904) 358-1551
Mailing address: 623 Beechwood St, Jacksonville, FL 32206-6236

Authorised official

Name: Jimmie P. Hicks
Title: Clinical Director
Phone: (904) 358-1211

Registered specialties

Point of Service Primary

Managed Care Organizations Taxonomy 305S00000X Licence 305S00000X-POINT OF (FL)

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Registry record

NPI: 1528165909
Entity type: Organization
NPI issued: 20 Sep 2006
Record last updated: 20 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.