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General NPI Number Information
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NPI Number | 1619599842
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Entity Type | Organization
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Legal Business Name | VILLAGE HOME HEALTHCARE LLC
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Dates
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Enumeration Date | 05/11/2020
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Last Update Date | 05/11/2020
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Provider Practice Location Address
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Address Line | 8343 PRINCETON SQUARE BLVD E APT 510
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City | JACKSONVILLE
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State | FL
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Zip | 32256-8368
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Country | US
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Telephone | 904-330-7616
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Fax |
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Provider Business Mailing Address
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Address Line | 8343 PRINCETON SQUARE BLVD E APT 510
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City | JACKSONVILLE
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State | FL
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Zip | 32256-8368
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO/FOUNDER
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Name | TAHITIA ELLIOTT
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Credential | MD
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Telephone | 904-330-7616
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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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