Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rehabilitation, Substance Use Disorder |
261QR0405X | |||
Community/Behavioral Health |
251S00000X | |||
Mental Health (Including Community Mental Health Center) |
261QM0801X | B4[14] | Community Mental Health Center | |
Multi-Specialty |
261QM1300X | 70 | Clinic or Group Practice |
| NPI # | 1588351308 |
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| LBN Legal business name | JEFFERSON CENTER FOR MENTAL HEALTH | ||||
| Authorized official | DAVID GOFF - (CHIEF FINANCIAL OFFICER) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | Yes | ||||
| Enumeration date | 04/21/2023 | ||||
| Last updated | 04/21/2023 - About 3 years ago | ||||
| Identifiers |
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