MEDICARE: UNIQUE SUPPORT AND TRANSPORTATION 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	251C00000X	Developmentally Disabled Services Day Training Agency
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1538976105
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIQUE SUPPORT AND TRANSPORTATION SERVICES LLC

Provider Business Mailing Address
First Line	:	5991 CHESTER AVE STE 105
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-2265
Country	:	US
Telephone Number	:	904-250-7363
Fax Number	:	904-374-2121

Provider Business Practice Location Address
First Line	:	5991 CHESTER AVE STE 105
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-2265
Country	:	US
Telephone Number	:	904-250-7363
Fax Number	:	904-374-2121

Authorized Official
Title or Position	:	OWNER
Name	:	ERICA KAY EVANS
Credential	:
Telephone Number	:	904-250-7363

Provider Enumeration Date	:	12/16/2024
Last Update Date	:	01/14/2026

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