MEDICARE: MOTHERLY HANDS INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QD1600X	Developmental Disabilities Clinic/Center
2	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care
3	253Z00000X	In Home Supportive Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710625900
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOTHERLY HANDS INC.

Provider Business Mailing Address
First Line	:	13341 ENGLISH PEAK COURT
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32258-5502
Country	:	US
Telephone Number	:	904-345-1914
Fax Number	:

Provider Business Practice Location Address
First Line	:	13341 ENGLISH PEAK COURT
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32258-5502
Country	:	US
Telephone Number	:	904-345-1914
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ELIZETTE TAYLOR
Credential	:
Telephone Number	:	904-345-1914

Provider Enumeration Date	:	05/26/2022
Last Update Date	:	05/26/2022

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Directions to “MOTHERLY HANDS INC. ” Practice Location

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