Healthcare Provider Details

I. General information

NPI: 1124947544
Provider Name (Legal Business Name): SJW HOMECARE SERVICE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2251 OSHKOSH CT
ORLANDO FL
32818-5208
US

IV. Provider business mailing address

2251 OSHKOSH CT
ORLANDO FL
32818-5208
US

V. Phone/Fax

Practice location:
  • Phone: 407-583-9447
  • Fax: 407-601-6992
Mailing address:
  • Phone: 407-583-9447
  • Fax: 407-601-6992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: YOLETTE PACIUS
Title or Position: OWNER
Credential:
Phone: 407-583-9447