Family Health Source

LBN: Northeast Florida Health Services, Inc.
Family Health Source is an health care organization with primary practice located at 801 Beville Rd Ste 101&102 , South Daytona FL 32119-1860. The organization recently has only one registered license in Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), which is considered as the primary health care specialty. Northeast Florida Health Services, Inc. can be contacted via phone (386) 267-6214, or through Collier, Rebecca via phone (386) 202-6025.

Contact Information

Primary practice address
801 Beville Rd Ste 101&102 South Daytona FL 32119-1860
Phone: (386) 267-6214
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Collier, Rebecca
Phone: (386) 202-6025

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X

Profile Details

NPI number 1396282208
LBN Legal business name Northeast Florida Health Services, Inc.
DBA Doing business as Family Health Source
Authorized official Collier, Rebecca
Entity Organization
Organization subpart 1 Yes
Enumeration date Jan 30th, 2017
Last updated Aug 10th, 2021 - about 4 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 1396282208 NPPES
Florida MEDICAID 687955111

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