Provider Demographics
NPI:1891567988
Name:CELEARN LOVING CARE AGENCY, LLC
Entity Type:Organization
Organization Name:CELEARN LOVING CARE AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHELTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-586-2406
Mailing Address - Street 1:6026 WILSON BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32210-3906
Mailing Address - Country:US
Mailing Address - Phone:305-970-3664
Mailing Address - Fax:
Practice Address - Street 1:6026 WILSON BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-3906
Practice Address - Country:US
Practice Address - Phone:305-970-3664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty