Provider Demographics
NPI:1043679749
Name:UNITED HOMEMAKER&COMPANIONSERVICE,INC
Entity Type:Organization
Organization Name:UNITED HOMEMAKER&COMPANIONSERVICE,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICIAL M
Authorized Official - Prefix:
Authorized Official - First Name:NACHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELDOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-444-8367
Mailing Address - Street 1:900 CESERY BLVD STE 117
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32211-5687
Mailing Address - Country:US
Mailing Address - Phone:904-444-8367
Mailing Address - Fax:
Practice Address - Street 1:900 CESERY BLVD STE 117
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211-5687
Practice Address - Country:US
Practice Address - Phone:904-444-8367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-23
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X
FL374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003805000Medicaid
FL016787100Medicaid