Provider Demographics
NPI:1831562875
Name:SPECIAL HEARTS SUPPORTS & SERVICES LLC
Entity type:Organization
Organization Name:SPECIAL HEARTS SUPPORTS & SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWENER
Authorized Official - Prefix:
Authorized Official - First Name:JASMIN
Authorized Official - Middle Name:C
Authorized Official - Last Name:BYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-415-5906
Mailing Address - Street 1:8024 SPRINGTREE RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32210-4534
Mailing Address - Country:US
Mailing Address - Phone:904-415-5906
Mailing Address - Fax:
Practice Address - Street 1:8024 SPRINGTREE RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-4534
Practice Address - Country:US
Practice Address - Phone:904-415-5906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-12
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health