Provider Demographics
NPI:1821696899
Name:CBHH ONE LIFE AGENCY LLC
Entity Type:Organization
Organization Name:CBHH ONE LIFE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHELIA
Authorized Official - Middle Name:G
Authorized Official - Last Name:INUSAH
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:865-235-9617
Mailing Address - Street 1:13296 SMITHWICK LN
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32226-0716
Mailing Address - Country:US
Mailing Address - Phone:865-235-9617
Mailing Address - Fax:904-353-2793
Practice Address - Street 1:1726 N MAIN ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32206-4404
Practice Address - Country:US
Practice Address - Phone:505-287-5565
Practice Address - Fax:904-353-2793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-13
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty