Healthcare Provider Details

I. General information

NPI: 1558034298
Provider Name (Legal Business Name): SURROUNDING WITH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2021
Last Update Date: 07/28/2021
Certification Date: 07/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8664 JULIA MARIE CIR
JACKSONVILLE FL
32210-0416
US

IV. Provider business mailing address

8664 JULIA MARIE CIR
JACKSONVILLE FL
32210-0416
US

V. Phone/Fax

Practice location:
  • Phone: 904-762-3894
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name: DESTEIRA HAMILTON
Title or Position: OWNER
Credential:
Phone: 904-762-3894