Healthcare Provider Details

I. General information

NPI: 1073105367
Provider Name (Legal Business Name): KALL FOR KARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2021
Last Update Date: 02/08/2021
Certification Date: 02/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 SMITH ST
ST AUGUSTINE FL
32084-0735
US

IV. Provider business mailing address

146 SMITH ST
ST AUGUSTINE FL
32084-0735
US

V. Phone/Fax

Practice location:
  • Phone: 904-254-9308
  • Fax:
Mailing address:
  • Phone:
  • 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 Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CORATTA MANSELL
Title or Position: OWNER
Credential:
Phone: 904-254-9308