MEDICARE: HANDS OF LOVE HOME HEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1003520834
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HANDS OF LOVE HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	9435 LOVAGE LN
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32219-2215
Country	:	US
Telephone Number	:	904-210-9745
Fax Number	:

Provider Business Practice Location Address
First Line	:	9435 LOVAGE LN
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32219-2215
Country	:	US
Telephone Number	:	904-210-9745
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JESSICA Y VINCENT
Credential	:
Telephone Number	:	904-210-9745

Provider Enumeration Date	:	01/06/2023
Last Update Date	:	01/06/2023

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Directions to “HANDS OF LOVE HOME HEALTH LLC ” Practice Location

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