OrganizationActive
Authentically You, LLC
NPI 1326559097 · Community/Behavioral Health Agency · Saint Augustine, FL
Provider details
- NPI number
- 1326559097
- Entity type
- Organization
- Primary specialty
- Community/Behavioral Health AgencyAgencies
- Organization subpart
- No
- Authorized official
- Amanda Payne, Owner(904) 629-1565
- License
- MH13243 (FL)
Specialties & taxonomies
Agencies
Practice location
109 Nature Walk Pkwy Unit 104
Saint Augustine, FL 32092-5065
Phone: (904) 629-1565
Fax: (904) 562-3465
Approximate (ZIP-level) locationGet directions
Mailing address
109 Nature Walk Pkwy Unit 104
Saint Augustine, FL 32092-5065
Additional practice locations (1)
- 701 Market St Ste 103bSaint Augustine, FL 32095-8803Phone: (904) 629-1565
Registry dates
- Enumerated
- 2017-10-20
- Last updated
- 2019-03-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.