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General NPI Number Information
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NPI Number | 1104545953
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Entity Type | Organization
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Legal Business Name | CARTERS CONFIDENT CARE
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Dates
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Enumeration Date | 08/24/2022
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Last Update Date | 09/20/2024
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Provider Practice Location Address
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Address Line | 678 SE BAYA DR
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City | LAKE CITY
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State | FL
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Zip | 32025-6038
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Country | US
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Telephone | 386-361-3839
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Fax | 386-381-1099
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Provider Business Mailing Address
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Address Line | 678 SE BAYA DR
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City | LAKE CITY
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State | FL
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Zip | 32025-6038
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Country | US
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Telephone | 386-361-3839
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Fax | 386-381-1099
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | BLENDA A JONES CARTER
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Credential | RN
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Telephone | 386-438-4488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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