Healthcare Provider Details

I. General information

NPI: 1235872821
Provider Name (Legal Business Name): CHANGING HANDS HOME-CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2022
Last Update Date: 07/15/2024
Certification Date: 07/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6966 JACK HORNER LN
JACKSONVILLE FL
32210-3620
US

IV. Provider business mailing address

6966 JACK HORNER LN
JACKSONVILLE FL
32210-3620
US

V. Phone/Fax

Practice location:
  • Phone: 904-437-2843
  • Fax:
Mailing address:
  • Phone: 904-437-2843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: FREDISHA WHITE
Title or Position: OWNER
Credential:
Phone: 904-437-2843