Healthcare Provider Details

I. General information

NPI: 1295484400
Provider Name (Legal Business Name): A GIFT OF CARING SUPPORT SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2022
Last Update Date: 07/30/2022
Certification Date: 07/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1524 DETROIT ST
JACKSONVILLE FL
32254-1927
US

IV. Provider business mailing address

1524 DETROIT ST
JACKSONVILLE FL
32254-1927
US

V. Phone/Fax

Practice location:
  • Phone: 904-575-7281
  • Fax:
Mailing address:
  • Phone:
  • 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 Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: DOROTHY WASHINGTON
Title or Position: OWNER
Credential:
Phone: 904-575-7281