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General NPI Number Information
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NPI Number | 1184399156
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Entity Type | Organization
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Legal Business Name | CONVAL-AIDE ENTERPRISE GROUP LLC
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Dates
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Enumeration Date | 08/12/2021
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Last Update Date | 08/12/2021
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Provider Practice Location Address
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Address Line | 9 N 14TH ST
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City | FERNANDINA BEACH
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State | FL
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Zip | 32034-5120
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Country | US
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Telephone | 904-277-0006
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Fax | 904-277-0017
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Provider Business Mailing Address
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Address Line | 9 N 14TH ST
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City | FERNANDINA BEACH
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State | FL
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Zip | 32034-5120
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Country | US
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Telephone | 904-277-0006
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Fax | 904-277-0017
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | DAVID F O'STEEN
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Credential |
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Telephone | 904-277-0006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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