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General NPI Number Information
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NPI Number | 1629216395
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Entity Type | Organization
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Legal Business Name | HOMECARE FRIENDS, LLC
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Dates
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Enumeration Date | 02/03/2009
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Last Update Date | 02/03/2009
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Provider Practice Location Address
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Address Line | 1863 WELLS RD SUITE 176
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City | ORANGE PARK
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State | FL
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Zip | 32073
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Country | US
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Telephone | 904-239-3154
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Fax |
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Provider Business Mailing Address
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Address Line | 2558 WOODHAVEN CT
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City | GREEN COVE SPRINGS
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State | FL
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Zip | 32043-5292
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Country | US
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Telephone | 904-234-8151
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. DESIREE MCDOWELL
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Credential | MM
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Telephone | 904-234-8151
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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 | HCS230401
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License Number State | FL
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