MEDICARE: DEAR ME AWAKE INC

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	376J00000X	Homemaker

General Provider Information

NPI Number	:	1861250615
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEAR ME AWAKE INC

Provider Business Mailing Address
First Line	:	2946 W 11TH ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32254-1925
Country	:	US
Telephone Number	:	904-578-3362
Fax Number	:

Provider Business Practice Location Address
First Line	:	2946 W 11TH ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32254-1925
Country	:	US
Telephone Number	:	904-578-3362
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. CHALEAH MARTIA MYRICK
Credential	:
Telephone Number	:	904-578-3362

Provider Enumeration Date	:	03/07/2024
Last Update Date	:	03/08/2024

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Directions to “DEAR ME AWAKE INC ” Practice Location

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