Provider Demographics
NPI:1023718426
Name:LUCID HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:LUCID HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING / CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLEY
Authorized Official - Middle Name:LINACRA CANDIE
Authorized Official - Last Name:LAW
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:904-599-9980
Mailing Address - Street 1:6620 SOUTHPOINT DR S STE 450C
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-0912
Mailing Address - Country:US
Mailing Address - Phone:904-599-9980
Mailing Address - Fax:
Practice Address - Street 1:6620 SOUTHPOINT DR S STE 450C
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-0912
Practice Address - Country:US
Practice Address - Phone:904-599-9980
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health