Provider Demographics
NPI:1295891398
Name:PERSONAL TOUCH NON-MEDICAL HOME CARE, INC.
Entity type:Organization
Organization Name:PERSONAL TOUCH NON-MEDICAL HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYUBA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLDAVSKIY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-521-6776
Mailing Address - Street 1:10164 ARROWHEAD DR
Mailing Address - Street 2:PERSONAL TOUCH NON-MEDICAL HOME CARE, INC.
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-5938
Mailing Address - Country:US
Mailing Address - Phone:904-521-6776
Mailing Address - Fax:904-260-7884
Practice Address - Street 1:10164 ARROWHEAD DR
Practice Address - Street 2:PERSONAL TOUCH NON-MEDICAL HOME CARE, INC.
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-5938
Practice Address - Country:US
Practice Address - Phone:904-521-6776
Practice Address - Fax:904-260-7884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-31
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL229225251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL689193400Medicaid