MEDICARE: THE PERFECT HEALING HANDS 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1720922867
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE PERFECT HEALING HANDS LLC

Provider Business Mailing Address
First Line	:	5620 COLLINS RD APT 1001
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32244-6919
Country	:	US
Telephone Number	:	904-200-9108
Fax Number	:

Provider Business Practice Location Address
First Line	:	5620 COLLINS RD APT 1001
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32244-6919
Country	:	US
Telephone Number	:	904-200-9108
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	SHANTELLE THOMPSON
Credential	:
Telephone Number	:	904-200-9108

Provider Enumeration Date	:	04/17/2026
Last Update Date	:	04/17/2026

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