Healthcare Provider Details

I. General information

NPI: 1326802224
Provider Name (Legal Business Name): LOVE FROM YOUR HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2024
Last Update Date: 02/12/2024
Certification Date: 02/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1311 NEVA ST
JACKSONVILLE FL
32205-6816
US

IV. Provider business mailing address

5501 WESCONNETT BLVD UNIT 14927
JACKSONVILLE FL
32244-1908
US

V. Phone/Fax

Practice location:
  • Phone: 904-962-3781
  • Fax:
Mailing address:
  • Phone: 904-667-1286
  • 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 Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name: SALENA RICHMOND
Title or Position: CEO
Credential:
Phone: 904-962-3781