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General NPI Number Information
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NPI Number | 1346119450
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Entity Type | Organization
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Legal Business Name | 1ST CARE SERVICE & SUPPORT, LLC
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Dates
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Enumeration Date | 11/05/2025
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 10912 WAHINE DR S
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City | JACKSONVILLE
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State | FL
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Zip | 32246-9446
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Country | US
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Telephone | 904-503-7040
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Fax |
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Provider Business Mailing Address
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Address Line | 10912 WAHINE DR S
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City | JACKSONVILLE
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State | FL
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Zip | 32246-9446
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Country | US
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Telephone | 904-503-7040
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | DR. KENNETH BUTLER
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Credential |
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Telephone | 904-554-0912
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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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