Healthcare Provider Details

I. General information

NPI: 1245849819
Provider Name (Legal Business Name): SEVEN BRIDGES SUPPORT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2020
Last Update Date: 07/29/2020
Certification Date: 07/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1652 FAIRWAY RIDGE DR
FLEMING ISLAND FL
32003-8253
US

IV. Provider business mailing address

1652 FAIRWAY RIDGE DR
FLEMING ISLAND FL
32003-8253
US

V. Phone/Fax

Practice location:
  • Phone: 904-305-3898
  • Fax:
Mailing address:
  • Phone: 904-305-3898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DANA FLOWERS
Title or Position: CEO
Credential:
Phone: 904-710-2760