MEDICARE: A GIFT OF CARING SUPPORT SERVICES, 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	374U00000X	Home Health Aide
2	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295484400
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A GIFT OF CARING SUPPORT SERVICES, LLC

Provider Business Mailing Address
First Line	:	1524 DETROIT ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32254-1927
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1524 DETROIT ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32254-1927
Country	:	US
Telephone Number	:	904-575-7281
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DOROTHY WASHINGTON
Credential	:
Telephone Number	:	904-575-7281

Provider Enumeration Date	:	03/23/2022
Last Update Date	:	07/30/2022

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