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NPI 1265299697

NPI 1265299697 : ABUNDANT COMFORT HOME HEALTH AGENCY LLC : JACKSONVILLE, FL

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General NPI Number Information
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    NPI Number           |    1265299697
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    Entity Type          |    Organization 
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    Legal Business Name  |    ABUNDANT COMFORT HOME HEALTH AGENCY LLC 
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Dates
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    Enumeration Date     |    03/04/2024
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    Last Update Date     |    03/04/2024
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Provider Practice Location Address
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    Address Line         |    1445 FALABELLA DR 
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    City                 |    JACKSONVILLE
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    State                |    FL
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    Zip                  |    32218-7995
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    Country              |    US
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    Telephone            |    904-258-6944
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    8717 MERSEYSIDE AVE 
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    City                 |    JACKSONVILLE
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    State                |    FL
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    Zip                  |    32219-4353
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    Country              |    US
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    Telephone            |    904-258-6944
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |     KATYANA M JOHNSON 
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    Credential           |    
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    Telephone            |    904-258-6944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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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 #3
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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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