NPIMap

Organization Active NPI

Clay Behavioral Health Center, Inc.

  • Community/Behavioral Health Agency
  • Green Cove Springs, FL
National Provider Identifier
1417520214
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CLAY BEHAVIORAL HEALTH CENTER, INC.
Practice address
1345 Idlewild Ave BLDG D
Green Cove Springs, FL 32043-3804
Phone
(904) 529-2233
NPI assigned
Jul 20, 2021
Last updated
Mar 20, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
CLAY BEHAVIORAL HEALTH CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Teresa Gaskins
Title
Fiscal Relations Supervisor
Phone
(904) 291-5561

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1345 Idlewild Ave BLDG D
Green Cove Springs, FL 32043-3804

Mailing address

41 Knight Boxx Rd
Orange Park, FL 32065-7305
Phone (904) 278-5644

Other identifiers 1

IdentifierTypeStateIssuer
060411904MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Clay Cty Behavioral Hea10 organizations share this tax ID, including this one
Part of
Clay Cty Behavioral Hea

Other organizations with this tax ID 9

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

Locations

1345 Idlewild Ave
Bldg D
Green Cove Springs, FL 32043
Phone (904) 529-2233

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742428800000",
    "number": "1417520214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 KNIGHT BOXX RD",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320657305",
            "telephone_number": "904-278-5644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 IDLEWILD AVE BLDG D",
            "city": "GREEN COVE SPRINGS",
            "state": "FL",
            "postal_code": "320433804",
            "telephone_number": "904-529-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAY BEHAVIORAL HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLAY BEHAVIORAL HEALTH CENTER, INC.",
        "enumeration_date": "2021-07-20",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A",
        "authorized_official_last_name": "GASKINS",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "FISCAL RELATIONS SUPERVISOR",
        "authorized_official_telephone_number": "904-291-5561"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060411904",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Cove Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; 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.