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General NPI Number Information
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NPI Number | 1609172469
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Entity Type | Organization
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Legal Business Name | GENERATIONS IN HOME CARE
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Dates
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Enumeration Date | 01/26/2011
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Last Update Date | 01/26/2011
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Provider Practice Location Address
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Address Line | 6155 HIGHWAY 17 S
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City | GREEN COVE SPRINGS
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State | FL
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Zip | 32043-4930
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Country | US
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Telephone | 904-529-7325
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Fax | 904-529-7325
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Provider Business Mailing Address
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Address Line | 6155 HIGHWAY 17 S
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City | GREEN COVE SPRINGS
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State | FL
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Zip | 32043-4930
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Country | US
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Telephone | 904-529-7325
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. DENISE ANN SMITH
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Credential | R.N.
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Telephone | 904-993-8243
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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 | 231601
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License Number State | FL
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