| NPI | 1356094809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LASHAN PHILLIPS-WASHINGTON Owner 904-233-9627 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 251E00000X Home Health |
| 253Z00000X In Home Supportive Care | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 261QA0600X Clinic/Center, Adult Day Care | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2022-02-03 |
| Last Update Date | 2025-08-10 |