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General NPI Number Information
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NPI Number | 1427725837
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Entity Type | Organization
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Legal Business Name | ONE CALL AWAY HOME CARE & STAFFING LLC
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Dates
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Enumeration Date | 08/24/2021
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Last Update Date | 08/24/2021
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Provider Practice Location Address
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Address Line | 13720 OLD SAINT AUGUSTINE RD STE 8-236
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City | JACKSONVILLE
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State | FL
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Zip | 32258-7414
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Country | US
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Telephone | 866-974-6632
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Fax |
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Provider Business Mailing Address
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Address Line | 13720 OLD SAINT AUGUSTINE RD STE 8-236
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City | JACKSONVILLE
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State | FL
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Zip | 32258-7414
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Country | US
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Telephone | 866-974-6632
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Fax |
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Authorized Official
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Title or Position | OWNER/ ADMINISTRATOR
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Name | LATASHA BURGESS
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Credential |
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Telephone | 866-974-6632
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral 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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Taxonomy #3
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #5
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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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