MEDICARE: HOME INSTEAD SENIOR CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	299992175	FL

General Provider Information

NPI Number	:	1508294802
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME INSTEAD SENIOR CARE

Provider Business Mailing Address
First Line	:	9191 R G SKINNER PKWY
Second Line	:	STE. 803
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-9655
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9191 R G SKINNER PKWY
Second Line	:	STE. 803
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-9655
Country	:	US
Telephone Number	:	904-363-6699
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DAVID HILL
Credential	:
Telephone Number	:	904-363-6699

Provider Enumeration Date	:	10/23/2013
Last Update Date	:	10/23/2013

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Directions to “HOME INSTEAD SENIOR CARE ” Practice Location

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