Healthcare Provider Details

I. General information

NPI: 1851209159
Provider Name (Legal Business Name): NURSE KAY'S RESIDENTIAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2026
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8534 ADDISON RD
JACKSONVILLE FL
32208-1923
US

IV. Provider business mailing address

6818 HOMER RD E
JACKSONVILLE FL
32209-1645
US

V. Phone/Fax

Practice location:
  • Phone: 904-554-9961
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: KETURAH JONES
Title or Position: RN
Credential:
Phone: 904-554-9961