Healthcare Provider Details

I. General information

NPI: 1134821499
Provider Name (Legal Business Name): ETERNITY HELPING HAND INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 03/20/2023
Certification Date: 03/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4669 LINCREST DR S
JACKSONVILLE FL
32208-1950
US

IV. Provider business mailing address

4669 LINCREST DR S
JACKSONVILLE FL
32208-1950
US

V. Phone/Fax

Practice location:
  • Phone: 904-452-6225
  • Fax:
Mailing address:
  • Phone: 904-452-6225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: JESSICA K JOINER
Title or Position: CEO
Credential: CMA
Phone: 904-452-6225