Provider Demographics
NPI:1376336032
Name:RAPHAEL COMPANION CARE INC.
Entity type:Organization
Organization Name:RAPHAEL COMPANION CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CESTAU
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-586-5665
Mailing Address - Street 1:218 LARKIN PL UNIT 112
Mailing Address - Street 2:
Mailing Address - City:ST JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-6976
Mailing Address - Country:US
Mailing Address - Phone:904-586-5665
Mailing Address - Fax:
Practice Address - Street 1:218 LARKIN PL UNIT 112
Practice Address - Street 2:
Practice Address - City:ST JOHNS
Practice Address - State:FL
Practice Address - Zip Code:32259-6976
Practice Address - Country:US
Practice Address - Phone:904-586-5665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-27
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health