Healthcare Provider Details

I. General information

NPI: 1639088107
Provider Name (Legal Business Name): LIONHEARTT SUPPORT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2086 MEHARRY AVE
JACKSONVILLE FL
32209-2624
US

IV. Provider business mailing address

2086 MEHARRY AVE
JACKSONVILLE FL
32209-2624
US

V. Phone/Fax

Practice location:
  • Phone: 904-609-6800
  • Fax:
Mailing address:
  • Phone: 904-609-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: DESREE BOYKIN
Title or Position: DIRECTOR OF CARE / MEDICAL BILLER
Credential:
Phone: 904-866-3870