MEDICARE: G A C SUPPORT SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251E00000X	Home Health Agency
2	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
3	372600000X	Adult Companion
4	376J00000X	Homemaker
5	385H00000X	Respite Care
6	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care
7	253Z00000X	In Home Supportive Care 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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932719333
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	G A C SUPPORT SERVICES LLC

Provider Business Mailing Address
First Line	:	6316 SAN JUAN AVE STE 41K
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32210-2831
Country	:	US
Telephone Number	:	904-203-0891
Fax Number	:	904-395-4310

Provider Business Practice Location Address
First Line	:	6316 SAN JUAN AVE STE 41K
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32210-2831
Country	:	US
Telephone Number	:	877-720-8455
Fax Number	:	904-395-4310

Authorized Official
Title or Position	:	OWNER
Name	:	JAMILYA JONES
Credential	:
Telephone Number	:	904-747-2084

Provider Enumeration Date	:	07/31/2020
Last Update Date	:	04/06/2023

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Directions to “G A C SUPPORT SERVICES LLC ” Practice Location

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