Healthcare Provider Details

I. General information

NPI: 1821555905
Provider Name (Legal Business Name): CARE AT HOME COMPANIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2019
Last Update Date: 02/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9438 ARBOR OAK LN
JACKSONVILLE FL
32208-8428
US

IV. Provider business mailing address

9438 ARBOR OAK LN
JACKSONVILLE FL
32208-8428
US

V. Phone/Fax

Practice location:
  • Phone: 904-303-3193
  • Fax:
Mailing address:
  • Phone: 904-303-3193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARY DAVIS-JOHNSON
Title or Position: MANAGER
Credential:
Phone: 904-303-3193