Provider Demographics
NPI:1598179251
Name:JEFFERSON HEALTH CARE
Entity Type:Organization
Organization Name:JEFFERSON HEALTH CARE
Other - Org Name:FELICIA JEFFERSON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:JEFFERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-226-6444
Mailing Address - Street 1:6859 LENOX AVE # 13
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32205-6149
Mailing Address - Country:US
Mailing Address - Phone:904-226-6444
Mailing Address - Fax:
Practice Address - Street 1:6859 LENOX AVE # 13
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32205-6149
Practice Address - Country:US
Practice Address - Phone:904-226-6444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-19
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL233454251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health