Healthcare Provider Details
I. General information
NPI: 1508021452
Provider Name (Legal Business Name): HOMEBOUND ALTERNATIVES INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/21/2008
Last Update Date: 07/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8663 SAN SERVERA DR E
JACKSONVILLE FL
32217-4614
US
IV. Provider business mailing address
PO BOX 58178
JACKSONVILLE FL
32241-8178
US
V. Phone/Fax
- Phone: 904-268-2552
- Fax:
- Phone: 904-268-2552
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 347C00000X |
| Taxonomy | Private Vehicle |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SARA
MOORE
Title or Position: OWNER
Credential:
Phone: 904-268-2552