| 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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