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General NPI Number Information
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NPI Number | 1710356332
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Entity Type | Organization
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Legal Business Name | HEAVENLY ANGELS HOMEMAKER & COMPANION SERVICES
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Dates
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Enumeration Date | 09/24/2015
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Last Update Date | 09/24/2015
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Provider Practice Location Address
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Address Line | 9695 WATERSHED DR S
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City | JACKSONVILLE
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State | FL
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Zip | 32220-0903
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Country | US
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Telephone | 904-444-5581
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Fax |
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Provider Business Mailing Address
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Address Line | 9695 WATERSHED DR S
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City | JACKSONVILLE
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State | FL
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Zip | 32220-0903
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Country | US
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Telephone | 904-444-5581
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | JENNIFER D HARRELL
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Credential | CNA
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Telephone | 904-444-5581
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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 |
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License Number State | FL
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