Healthcare Provider Details

I. General information

NPI: 1619111317
Provider Name (Legal Business Name): HELPING HANDS HOUSING & DEVELOPMENTAL SERVICES AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2009
Last Update Date: 02/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12335 STOCKBRIDGE CT S
JACKSONVILLE FL
32258-1203
US

IV. Provider business mailing address

3617 CROWN POINT ROAD SUITE 8
JACKSONVILLE FL
32257-9010
US

V. Phone/Fax

Practice location:
  • Phone: 904-993-3866
  • Fax:
Mailing address:
  • Phone: 904-303-4501
  • Fax: 904-619-0377

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. GUIDO ANIBAL GONZALEZ SR.
Title or Position: PRESIDENT
Credential:
Phone: 904-993-3866