Healthcare Provider Details

I. General information

NPI: 1811693104
Provider Name (Legal Business Name): A MOTHERS TOUCH HOME HEALTH & COMPANION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2023
Last Update Date: 02/07/2023
Certification Date: 02/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2819 BEGONIA RD
JACKSONVILLE FL
32209-2301
US

IV. Provider business mailing address

2819 BEGONIA RD
JACKSONVILLE FL
32209-2301
US

V. Phone/Fax

Practice location:
  • Phone: 904-442-0780
  • Fax:
Mailing address:
  • Phone: 904-442-0780
  • 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 Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: ANTONEISHA T HAROLD
Title or Position: OWNER
Credential:
Phone: 904-442-0780