Provider Demographics
NPI:1215735808
Name:COMMUNITY HEALTH INITIATIVES GROUP, INC.
Entity type:Organization
Organization Name:COMMUNITY HEALTH INITIATIVES GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:MOUNT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-699-2332
Mailing Address - Street 1:8411 SOUTHSIDE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-0755
Mailing Address - Country:US
Mailing Address - Phone:904-323-4488
Mailing Address - Fax:904-323-4488
Practice Address - Street 1:934 ARLINGTON RD N
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211-5956
Practice Address - Country:US
Practice Address - Phone:904-323-4488
Practice Address - Fax:904-323-4488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No3336C0002XSuppliersPharmacyClinic Pharmacy