COMMUNITY REHABILITATION CENTER, INC. (NPI# 1770868010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770868010 |
| Entity Type | Organization |
| Organization Name | COMMUNITY REHABILITATION CENTER, INC. |
| Other Organization Name | CRC |
| Practice Address |
623 Beechwood St Jacksonville FL 32206-6236 |
| Practice Telephone | 9043581211 |
| Practice Fax Number | 9043581551 |
| Mailing Telephone | 9043581211 |
| Mailing Fax Number | 9043581551 |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2011-10-19 |
| Authorized Official Name | MR. WILLIAM C. JONES (CLINICAL THERAPIST) |
| Authorized Official Telephone | 9043581211 |
| Authorized Official Credential | LMHC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | MH0000054 | FL | Agencies |
| Other Name | Type Code |
|---|---|
| CRC | Doing Business As Name - Organization |
| Street Address |
623 BEECHWOOD ST |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32206-6236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952304511 | Communtiy Rehabilitation Center, Inc. | Case Management | 623 Beechwood St, Jacksonville, FL 32206-6236 | 2005-05-27 |
| 1033543343 | Erakal Goodman | Counselor | 623 Beechwood St, Jacksonville, FL 32206-6236 | 2013-08-23 |
| 1740621564 | Latoya Oates | Counselor | 623 Beechwood St, Jacksonville, FL 32206-6236 | 2013-07-09 |
| 1871867762 | Kimyata Marie Whaley | Case Manager/Care Coordinator | 623 Beechwood St, Jacksonville, FL 32206-6236 | 2012-02-24 |
| 1235412206 | Mattie G Lusco | Case Management | 623 Beechwood St, Jacksonville, FL 32206-6236 | 2011-09-26 |
| 1902031859 | Albert N Crane Jr. | Counselor | 623 Beechwood St, Jacksonville, FL 32206-6236 | 2009-05-21 |
| 1528293461 | Sauna L Hicks | Counselor | 623 Beechwood St, Jacksonville, FL 32206-6236 | 2009-05-21 |
| 1659520047 | John Calvin Hale | Case Manager/Care Coordinator | 623 Beechwood St, 623 Beechwood St, Jacksonville, FL 32206-6236 | 2008-09-10 |
| 1508991332 | Community Rehabilitation Center, Inc | Community/Behavioral Health | 623 Beechwood St, Jacksonville, FL 32206-6236 | 2007-02-22 |
| 1790854669 | Communityrehabilitation Center Inc | Day Training, Developmentally Disabled Services | 623 Beechwood St, Jacksonville, FL 32206-6236 | 2006-11-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790275543 | Marvin Victor Sindel IIi | Nurse Practitioner | 1241 E 8th St, Jacksonville, FL 32206 | 2018-05-17 |
| 1982126553 | Marcia Camille Holloway | In Home Supportive Care | 647 East 31th Street, Jacksonville, FL 32206 | 2017-07-14 |
| 1407302656 | Tahnita Fleming | Day Training, Developmentally Disabled Services | 1309 Van Buren Street, Jacksonville, FL 32206 | 2016-08-28 |
| 1912202136 | Bishop Home Care, Inc | Clinic/Center | 1627 E 8th Street, Jacksonville, FL 32206 | 2011-01-19 |
| 1407183965 | Richard Adam Crosby | Chiropractor | 4211 North Pearl St., Jacksonville, FL 32206 | 2009-11-04 |
| 1346494903 | Delvenia Renee Mitchell | Specialist | 4515 N Pearl St Apt 2, Jacksonville, FL 32206 | 2008-11-10 |
| 1962662775 | Curtis Michael Bryant | Radiology | 2015 Jefferson Street, University of Florida Proton Institute, Jacksonville, FL 32206 | 2008-06-15 |
| 1932253879 | Gale Marie Cohen-weiss | Social Worker | Veterans Health System, Jacksonville Outpatient Clinic, 1833 Boulevard, Jacksonville, FL 32206 | 2007-01-22 |
| 1396817557 | Bella Caimol Ejercito | Internal Medicine | 4608 Norwood Ave, Jacksonville, FL 32206 | 2006-11-14 |
| 1962584433 | Jessica Ivette Warthen | Pharmacist | 1833 Boluevard, Department of Veterans Affairs; Mental Health Clinic, Jacksonville, FL 32206 | 2006-10-20 |
| Find all providers in zip 32206 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427632 | Sunzup Counseling and Wellness | Community/Behavioral Health | 3355 Claire Ln Apt 1116, Jacksonville, FL 32223-6662 | 2020-11-02 |
| 1063043420 | Elephant Clinic Ltd. | Community/Behavioral Health | 8 Unf Dr # 221, Jacksonville, FL 32224-7699 | 2020-02-03 |
| 1679056857 | Inspire To Rise Inc. | Community/Behavioral Health | 4603 Silverthorn Dr, Jacksonville, FL 32258-2010 | 2018-09-13 |
| 1558863787 | Positive Development, LLC | Community/Behavioral Health | 3840 Belfort Rd Ste 302, Jacksonville, FL 32216-8210 | 2018-03-04 |
| 1073012555 | Pivotal Step Services, Pllc | Community/Behavioral Health | 1106b Gum Branch Rd, Jacksonville, NC 28540-5743 | 2018-02-09 |
| 1518473594 | Werp LLC | Community/Behavioral Health | 5291 Collins Rd Lot 293, Jacksonville, FL 32244-5389 | 2017-12-28 |
| 1871007062 | National Youth Advocate Program, Inc | Community/Behavioral Health | 2200 Rosselle St, Jacksonville, FL 32204-3126 | 2017-11-27 |
| 1962913327 | Port Health Services | Community/Behavioral Health | 224 Memorial Dr Ste B, Jacksonville, NC 28546-6332 | 2017-10-12 |
| 1598282667 | B.e.h. Elderly Care LLC | Community/Behavioral Health | 5145 Timuquana Rd Apt 6, Jacksonville, FL 32210-8923 | 2017-08-29 |
| 1427598689 | Family Farms of Northeast Florida | Community/Behavioral Health | 16844 Ethel Rd, Jacksonville, FL 32218-1108 | 2017-03-06 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32206 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.