| NPI | 1922718774 |
|---|---|
| Doing Business As | PRUITTHEALTH @ HOME JACKSONVILLE |
| Entity Type | Organization |
| Authorized Contact | LYNETHIA NYTONYA HOLLEY Provider Enrollment Specialist 786-296-0751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Enumeration Date | 2022-12-02 |
| Last Update Date | 2022-12-02 |