| NPI | 1790516821 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVIDSON AUGUSTIN Mgr/ Administrator 904-616-7903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 251F00000X Home Infusion | |
| 315D00000X Hospice, Inpatient | |
| 343800000X Secured Medical Transport (VAN) | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 347C00000X Private Vehicle | |
| 385H00000X Respite Care | |
| 385HR2055X Respite Care Respite Care, Mental Illness, Child | |
| 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities | |
| 385HR2065X Respite Care Respite Care, Physical Disabilities, Child | |
| Enumeration Date | 2024-08-10 |
| Last Update Date | 2024-08-10 |