Healthcare Provider Details

I. General information

NPI: 1538306527
Provider Name (Legal Business Name): PEOPLE'S HOMEMAKER COMPANION SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2009
Last Update Date: 12/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 PARK ST SUITE 2
JACKSONVILLE FL
32204-2933
US

IV. Provider business mailing address

PO BOX 43441
JACKSONVILLE FL
32203-3441
US

V. Phone/Fax

Practice location:
  • Phone: 904-374-5450
  • Fax: 904-374-6854
Mailing address:
  • Phone: 904-374-5450
  • Fax: 904-374-5468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number230581
License Number StateFL

VIII. Authorized Official

Name: MRS. ANDRIA RENEE BROWN
Title or Position: ADMINISTRATOR
Credential:
Phone: 904-524-0024