Provider Demographics
NPI:1083476279
Name:PRN COMPANION AND COMPASSION HOME HEALTH AND STAFFING
Entity Type:Organization
Organization Name:PRN COMPANION AND COMPASSION HOME HEALTH AND STAFFING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHALONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:352-325-2849
Mailing Address - Street 1:1200 RIVERPLACE BLVD STE 105-1073
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-9046
Mailing Address - Country:US
Mailing Address - Phone:352-325-2849
Mailing Address - Fax:
Practice Address - Street 1:1200 RIVERPLACE BLVD STE 105-1073
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-9046
Practice Address - Country:US
Practice Address - Phone:352-325-2849
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-24
Last Update Date:2024-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health