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General NPI Number Information
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NPI Number | 1184515967
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Entity Type | Organization
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Legal Business Name | SHINE FOREVER HOME HEALTHCARE AGENCY LLC
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Dates
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Enumeration Date | 07/10/2025
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 2996 PLUM ORCHARD DR
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City | ORANGE PARK
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State | FL
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Zip | 32073-1607
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Country | US
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Telephone | 813-705-3945
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Fax |
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Provider Business Mailing Address
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Address Line | 13475 ATLANTIC BLVD STE 8
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City | JACKSONVILLE
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State | FL
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Zip | 32225-3290
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Country | US
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Telephone | 813-705-3945
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. KEVA N BROWN
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Credential |
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Telephone | 813-360-9645
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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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