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General NPI Number Information
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NPI Number | 1831856442
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Entity Type | Organization
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Legal Business Name | TAKS CARE GROUP LLC
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Dates
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Enumeration Date | 11/18/2021
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Last Update Date | 01/16/2024
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Provider Practice Location Address
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Address Line | 3830 WILLIAMSBURG PARK BLVD UNIT 4
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City | JACKSONVILLE
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State | FL
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Zip | 32257-9200
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Country | US
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Telephone | 904-217-8952
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Fax | 682-201-2130
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Provider Business Mailing Address
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Address Line | PO BOX 600865
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City | JACKSONVILLE
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State | FL
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Zip | 32260-0865
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Country | US
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Telephone | 904-217-8952
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Fax | 682-201-2130
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Authorized Official
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Title or Position | CEO
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Name | CHRISTELLE TAKOU OBEN
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Credential | APRN
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Telephone | 904-907-7768
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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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 |
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Taxonomy #3
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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