MEDICARE: GLORY BOUND HANDS FOR 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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1710731567
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLORY BOUND HANDS FOR HEALTH LLC

Provider Business Mailing Address
First Line	:	5821 SAN JUAN AVE APT 130
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32210-3014
Country	:	US
Telephone Number	:	904-731-6327
Fax Number	:

Provider Business Practice Location Address
First Line	:	5821 SAN JUAN AVE APT 130
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32210-3014
Country	:	US
Telephone Number	:	904-731-6327
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. SANSHEA GREEN
Credential	:
Telephone Number	:	904-731-6327

Provider Enumeration Date	:	04/16/2024
Last Update Date	:	04/16/2024

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Directions to “GLORY BOUND HANDS FOR HEALTH LLC ” Practice Location

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