Provider Demographics
NPI:1942860127
Name:GREATER IMPRESSIONS CARE SERVICES,LLC
Entity Type:Organization
Organization Name:GREATER IMPRESSIONS CARE SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAMESHIA
Authorized Official - Middle Name:DANETTE
Authorized Official - Last Name:SUMLAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-955-9404
Mailing Address - Street 1:6103 WINDING BRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32277-1451
Mailing Address - Country:US
Mailing Address - Phone:904-955-9404
Mailing Address - Fax:
Practice Address - Street 1:6103 WINDING BRIDGE DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32277-1451
Practice Address - Country:US
Practice Address - Phone:904-955-9404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-19
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care