| Prism Community Mental Health, Llc | |
|
351 Crossing Blvd Apt 911 Orange Park FL 32073-6241 | |
| (904) 654-3275 | |
| Not Available |
| Full Name | Prism Community Mental Health, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 351 Crossing Blvd Apt 911, Orange Park, Florida |
| Authorized Official Name and Position | Julie Lynn Johnson (OWNER/OPERATOR) |
| Authorized Official Contact | 9046543275 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prism Community Mental Health, Llc 351 Crossing Blvd Apt 911 Orange Park FL 32073-6241 Ph: (904) 654-3275 | Prism Community Mental Health, Llc 351 Crossing Blvd Apt 911 Orange Park FL 32073-6241 Ph: (904) 654-3275 |
| NPI Number | 1528790292 |
|---|---|
| Provider Enumeration Date | 06/30/2022 |
| Last Update Date | 06/30/2022 |
| Certification Date | 06/30/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528790292 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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