ONE STOP COMMUNITY BASE BEHAVIORAL HEALTHCARE INC NPI 1700360039

NPI Information

NPI: 1700360039
Provider Name: ONE STOP COMMUNITY BASE BEHAVIORAL HEALTHCARE INC
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
12058 SAN JOSE BLVD STE 903
JACKSONVILLE, FL
ZIP 32223
Phone: (894) 886-0361
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ONE STOP COMMUNITY BASE BEHAVIORAL HEALTHCARE INC is a mental health counselor in Jacksonville, FL. ONE STOP COMMUNITY BASE BEHAVIORAL HEALTHCARE INC NPI is 1700360039. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

12058 SAN JOSE BLVD STE 903
JACKSONVILLE, FL
ZIP 32223-667
Phone: (894) 886-0361
Fax: (904) 886-0382

The provider's authorized official is Farkhanda Khan .
The authorized official title is Therapist and has the following contact phone number (904) 403-3241.

The enumeration date for this NPI number is 9/21/2018 and was last updated on 9/21/2018.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health			Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1528489598	MEDICAID	FLORIDA

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: 11/14/2023

NPI Synchronization or Removal

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