Healthcare Provider Details

I. General information

NPI: 1497266928
Provider Name (Legal Business Name): HEALING AND HOPE MISSION, CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2017
Last Update Date: 03/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7038 ALANA RD
JACKSONVILLE FL
32211-4183
US

IV. Provider business mailing address

7038 ALANA RD
JACKSONVILLE FL
32211-4183
US

V. Phone/Fax

Practice location:
  • Phone: 904-520-1245
  • Fax:
Mailing address:
  • Phone: 904-520-1245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberARNP9287698
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License NumberARNP9207698
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberARNP9287698
License Number StateFL

VIII. Authorized Official

Name: GENEVIEVE N DOREUS
Title or Position: CHIEF OPERATING OFFICER
Credential: ARNP
Phone: 904-520-1245