Provider Type Icon

NORTHWEST BEHAVIORAL HEALTH SERVICES INC. NPI 1023016839


NPI Information

NPI: 1023016839
Provider Name: NORTHWEST BEHAVIORAL HEALTH SERVICES, INC.
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization

CLIA Number: 10D1095616

Address:
2392 EDGEWOOD AVE N
JACKSONVILLE, FL
ZIP 32254
Phone: (904) 781-7797
Get Directions

NORTHWEST BEHAVIORAL HEALTH SERVICES, INC. is a community behavioral health in Jacksonville, FL. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. NORTHWEST BEHAVIORAL HEALTH SERVICES, INC. NPI is 1023016839. The provider is registered as an organization entity type.

The provider's business location address is:

2392 EDGEWOOD AVE N
JACKSONVILLE, FL
ZIP 32254-725
Phone: (904) 781-7797
Fax: (904) 781-8685

The provider's authorized official is Terri D Glover .
The authorized official title is Executive Director, Ceo and has the following contact phone number (904) 781-0600.

The CLIA number assigned to this NPI record is 10D1095616 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/14/2005 and was last updated on 11/7/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251B00000XCase ManagementFLORIDANo
2251C00000XDay Training, Developmentally Disabled ServicesFLORIDANo
3251S00000XCommunity/Behavioral HealthFLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1029591400MEDICAIDFLORIDA
2029591401MEDICAIDFLORIDA
3284275OTHERFLORIDAHMO
4681396800MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.