NPIMap

Organization Active NPI

Mental Health Resource Center Inc

  • Community Health Clinic/Center
  • Jacksonville, FL
National Provider Identifier
1164092029
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
MENTAL HEALTH RESOURCE CENTER INC
Practice address
1636 Shadowood LN Ste 106
Jacksonville, FL 32207-2187
Phone
(904) 695-0249
Fax
(904) 695-7385
NPI assigned
Jul 1, 2021
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Robert Sommers, PH.D
Title
President/Ceo
Phone
(904) 743-1883

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

National Provider Directory
Tax ID family
Mental Health Resource Center Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1636 Shadowood Ln
Ste 106
Jacksonville, FL 32207
Phone (904) 695-0249

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Community Health Clinic/Center 261QC1500X Primary

Addresses

NPPES NPI Registry

Primary practice location

1636 Shadowood LN Ste 106
Jacksonville, FL 32207-2187

Mailing address

PO Box 19249
Jacksonville, FL 32245-9249
Phone (904) 743-1883

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 1, 2021.

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625097600000",
    "number": "1164092029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19249",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322459249",
            "telephone_number": "904-743-1883",
            "fax_number": "904-743-5309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1636 SHADOWOOD LN STE 106",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322072187",
            "telephone_number": "904-695-0249",
            "fax_number": "904-695-7385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH RESOURCE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-01",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A",
        "authorized_official_last_name": "SOMMERS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "904-743-1883",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.