Healthcare Provider Details

I. General information

NPI: 1558061994
Provider Name (Legal Business Name): RN DISABILITY & CONSULTING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2023
Last Update Date: 03/06/2023
Certification Date: 03/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4411 SUNBEAM RD # 56721
JACKSONVILLE FL
32257-7525
US

IV. Provider business mailing address

PO BOX 56721
JACKSONVILLE FL
32241-6721
US

V. Phone/Fax

Practice location:
  • Phone: 904-990-4774
  • Fax:
Mailing address:
  • Phone: 904-990-4774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. TA'SHARA T WHITEHEAD
Title or Position: MANAGER
Credential: RN
Phone: 904-990-4774