Provider Demographics
NPI:1275238453
Name:FAMILY CARING COMPANION SERVICES, LLC
Entity Type:Organization
Organization Name:FAMILY CARING COMPANION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKENZY-COOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-993-9158
Mailing Address - Street 1:5528 GREEN FOREST DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-1548
Mailing Address - Country:US
Mailing Address - Phone:904-993-9158
Mailing Address - Fax:904-683-9398
Practice Address - Street 1:5528 GREEN FOREST DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-1548
Practice Address - Country:US
Practice Address - Phone:904-993-9158
Practice Address - Fax:904-683-9398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-05
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty