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General NPI Number Information
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NPI Number | 1841062783
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Entity Type | Organization
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Legal Business Name | IN SEARCH OF A NEW BEGINNING, INC
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Dates
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Enumeration Date | 10/24/2023
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Last Update Date | 10/24/2023
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Provider Practice Location Address
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Address Line | 464 CRABAPPLE CT APT B
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City | ORANGE PARK
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State | FL
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Zip | 32073-8846
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Country | US
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Telephone | 904-444-3045
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Fax | 904-375-9451
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Provider Business Mailing Address
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Address Line | PO BOX 7064
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City | JACKSONVILLE
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State | FL
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Zip | 32238-0064
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Country | US
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Telephone | 904-444-3045
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Fax | 904-375-9451
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MS. PHYLLIS DIANE PORTER
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Credential |
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Telephone | 904-444-3045
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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