Jacksonville Youth Sanctuary

LBN: Jacksonville Youth Sanctuary
Jacksonville Youth Sanctuary is an health care organization with primary practice located at 4570 Saint Johns Ave Ste 3 , Jacksonville FL 32210-1844. The organization recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as the primary health care specialty. Jacksonville Youth Sanctuary can be contacted via phone (904) 389-5231, or through Rousset, Jennifer G via phone (904) 389-5231.

Contact Information

Primary practice address
4570 Saint Johns Ave Ste 3 Jacksonville FL 32210-1844
Phone: (904) 389-5231
Fax: (904) 677-8019
Website:
Map and Directions
Authorized official contact:
Name: Rousset, Jennifer G
Phone: (904) 389-5231

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X Florida

Profile Details

NPI number 1992933964
LBN Legal business name Jacksonville Youth Sanctuary
DBA Doing business as
Authorized official Rousset, Jennifer G
Entity Organization
Organization subpart 1 No
Enumeration date Jun 29th, 2009
Last updated Aug 12th, 2009 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992933964 NPPES
Florida MEDICAID 360358001

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