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General NPI Number Information
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NPI Number | 1962116632
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Entity Type | Organization
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Legal Business Name | MITCHELLS ALL AT HOME QUALITY CARE PROVIDER INC
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Dates
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Enumeration Date | 01/09/2023
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Last Update Date | 02/07/2023
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Provider Practice Location Address
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Address Line | 535 CHARLES PINCKNEY ST
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City | ORANGE PARK
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State | FL
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Zip | 32073-8782
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Country | US
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Telephone | 904-914-0782
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Fax |
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Provider Business Mailing Address
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Address Line | 535 CHARLES PINCKNEY ST
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City | ORANGE PARK
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State | FL
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Zip | 32073-8782
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Country | US
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Telephone | 904-914-0782
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. ALICIA P MITCHELL
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Credential |
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Telephone | 904-914-0782
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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