Healthcare Provider Details

I. General information

NPI: 1114962859
Provider Name (Legal Business Name): AHP HOME HEALTHCARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 10/19/2022
Certification Date: 10/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7737 LUEDERS AVE
JACKSONVILLE FL
32208-3623
US

IV. Provider business mailing address

7737 LUEDES AVE
JACKSONVILLE FL
32208-3623
US

V. Phone/Fax

Practice location:
  • Phone: 904-766-1285
  • Fax: 904-766-0995
Mailing address:
  • Phone: 904-766-1285
  • Fax: 904-766-0995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name: CHARLENE LOUISE AUSTIN
Title or Position: CEO
Credential:
Phone: 904-766-1285