Healthcare Provider Details

I. General information

NPI: 1992226179
Provider Name (Legal Business Name): HOMELIFE PERSONAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2017
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 ROBERTS VILLAGE CT STE 302
FRUIT COVE FL
32259-9560
US

IV. Provider business mailing address

48 ROBERTS VILLAGE CT STE 302
FRUIT COVE FL
32259-9560
US

V. Phone/Fax

Practice location:
  • Phone: 904-646-8993
  • Fax: 904-592-2220
Mailing address:
  • Phone: 904-646-8993
  • Fax: 904-592-2220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JULIE COMBS
Title or Position: OWNER/ADMINISTRATOR
Credential: RN
Phone: 904-646-8993