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General NPI Number Information
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NPI Number | 1295430858
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Entity Type | Organization
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Legal Business Name | BY YOUR SIDE SENIOR CARE
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Dates
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Enumeration Date | 04/03/2023
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Last Update Date | 09/19/2024
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Provider Practice Location Address
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Address Line | 1515 BUSINESS CENTER DR STE 3
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City | FLEMING ISLAND
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State | FL
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Zip | 32003-4401
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Country | US
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Telephone | 904-579-3059
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Fax | 904-644-7972
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Provider Business Mailing Address
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Address Line | 1515 BUSINESS CENTER DR STE 3
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City | FLEMING ISLAND
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State | FL
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Zip | 32003-4401
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Country | US
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Telephone | 904-579-3059
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Fax | 904-644-7972
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Authorized Official
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Title or Position | CEO OWNER
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Name | MARY ELIZABETH BLEDSOE
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Credential |
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Telephone | 904-579-3059
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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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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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