NPIMap

Organization Active NPI

Community Rehabilitation Center, Inc.

  • Community/Behavioral Health Agency
  • Jacksonville, FL
National Provider Identifier
1770868010
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MH0000054 Issued in FL
Legal business name
COMMUNITY REHABILITATION CENTER, INC.
Practice address
623 Beechwood St
Jacksonville, FL 32206-6236
Phone
(904) 358-1211
Fax
(904) 358-1551
NPI assigned
Oct 19, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

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

Authorized official

Name
Mr. William C. Jones, LMHC
Title
Clinical Therapist
Phone
(904) 358-1211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MH0000054 FL Primary

Addresses

Primary practice location

623 Beechwood St
Jacksonville, FL 32206-6236

Mailing address

623 Beechwood St
Jacksonville, FL 32206-6236
Phone (904) 358-1211

Other names 1

  • CRC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Community Rehabilitation Center Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318982400000",
    "number": "1770868010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 BEECHWOOD ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322066236",
            "telephone_number": "904-358-1211",
            "fax_number": "904-358-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 BEECHWOOD ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322066236",
            "telephone_number": "904-358-1211",
            "fax_number": "904-358-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY REHABILITATION CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-19",
        "last_updated": "2011-10-19",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "CLINICAL THERAPIST",
        "authorized_official_telephone_number": "904-358-1211",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "MH0000054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CRC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 19, 2011; 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.