=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619349651
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | U ENTERPRISES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/29/2015
-----------------------------------------------------
Last Update Date | 10/29/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 910 S WINTERHAWK DR SUITE 106
-----------------------------------------------------
City | ST AUGUSTINE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32086-3870
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 904-651-6933
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3555 US HIGHWAY 17 STE 1
-----------------------------------------------------
City | FLEMING ISLAND
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32003-7140
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 904-479-9603
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | GENERAL MANAGER
-----------------------------------------------------
Name | MR. PATRICK FRANCIS FARRELL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 904-479-9603
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 233891
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------