Provider Demographics
NPI:1164854212
Name:HOME FOR ME
Entity Type:Organization
Organization Name:HOME FOR ME
Other - Org Name:NONYE J NDUKA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NONYE
Authorized Official - Middle Name:JOE
Authorized Official - Last Name:NDUKA
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:904-716-7106
Mailing Address - Street 1:7655 COLLINS RIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-6422
Mailing Address - Country:US
Mailing Address - Phone:904-379-3746
Mailing Address - Fax:
Practice Address - Street 1:7655 COLLINS RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-6422
Practice Address - Country:US
Practice Address - Phone:904-379-3746
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-31
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL12373310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility