NPIMap

Organization Active NPI

Jacksonville Youth Center

  • Psychiatric Residential Treatment Facility
  • Jacksonville, FL
National Provider Identifier
1629098561
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
License
10609100000 Issued in FL
Legal business name
JACKSONVILLE YOUTH CENTER
Practice address
202 Century 21 Dr
Suite 1
Jacksonville, FL 32216-6812
Phone
(904) 724-6488
Fax
(904) 724-6072
NPI assigned
Jul 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Julie Wintz
Title
Administrator
Phone
(904) 724-6488

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X 10609100000 FL Primary

Addresses

Primary practice location

202 Century 21 Dr
Suite 1
Jacksonville, FL 32216-6812

Mailing address

202 Century 21 Dr
Suite 1
Jacksonville, FL 32216-6812
Phone (904) 724-6488

National Provider Directory

National Provider Directory
Tax ID family
Bristol Youth Academy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

202 Century 21 Dr
Ste 1
Jacksonville, FL 32216
Phone (904) 724-6488

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629098561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 CENTURY 21 DR",
            "address_2": "SUITE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166812",
            "telephone_number": "904-724-6488",
            "fax_number": "904-724-6072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 CENTURY 21 DR",
            "address_2": "SUITE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166812",
            "telephone_number": "904-724-6488",
            "fax_number": "904-724-6072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSONVILLE YOUTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WINTZ",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "904-724-6488"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "FL",
            "license": "10609100000",
            "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 Aug 22, 2020; 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.