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General NPI Number Information
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NPI Number | 1750564670
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Entity Type | Organization
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Legal Business Name | SHATARA'S PASSION CARE,INC
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Dates
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Enumeration Date | 12/13/2007
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Last Update Date | 12/13/2007
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Provider Practice Location Address
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Address Line | 117 W 32ND ST
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City | JACKSONVILLE
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State | FL
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Zip | 32206-6424
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Country | US
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Telephone | 904-400-5795
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Fax | 904-329-1376
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Provider Business Mailing Address
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Address Line | 117 W 32ND ST
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City | JACKSONVILLE
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State | FL
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Zip | 32206-6424
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Country | US
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Telephone | 904-400-5795
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Fax | 904-329-1376
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | MRS. TOYA BROWN
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Credential |
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Telephone | 904-400-5795
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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 | #230056
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License Number State | FL
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