Provider Demographics
NPI:1376297242
Name:CREDIBLE HOMECARE SERVICES, INC.
Entity Type:Organization
Organization Name:CREDIBLE HOMECARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANTONINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-523-4791
Mailing Address - Street 1:12627 SAN JOSE BLVD STE 504E
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-8641
Mailing Address - Country:US
Mailing Address - Phone:904-523-4791
Mailing Address - Fax:904-297-2670
Practice Address - Street 1:12627 SAN JOSE BLVD STE 504E
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-8641
Practice Address - Country:US
Practice Address - Phone:904-523-4791
Practice Address - Fax:904-297-2670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care