Provider Demographics
NPI:1538306527
Name:PEOPLE'S HOMEMAKER COMPANION SERVICE
Entity Type:Organization
Organization Name:PEOPLE'S HOMEMAKER COMPANION SERVICE
Other - Org Name:PEOPLE'S HOMEMAKING COMPANION SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDRIA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-524-0024
Mailing Address - Street 1:PO BOX 43441
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32203-3441
Mailing Address - Country:US
Mailing Address - Phone:904-374-5450
Mailing Address - Fax:904-374-5468
Practice Address - Street 1:650 PARK ST
Practice Address - Street 2:SUITE 2
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-2933
Practice Address - Country:US
Practice Address - Phone:904-374-5450
Practice Address - Fax:904-374-6854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-13
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL230581251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL691546996Medicaid