Provider Demographics
NPI:1881086981
Name:SINGLETARY HOMEMAKER COMPANION SVC. INC.
Entity type:Organization
Organization Name:SINGLETARY HOMEMAKER COMPANION SVC. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:AUDRA
Authorized Official - Middle Name:ALTAMESE
Authorized Official - Last Name:SINGLETARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-422-6732
Mailing Address - Street 1:244 W 54TH ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32208-4602
Mailing Address - Country:US
Mailing Address - Phone:904-422-6732
Mailing Address - Fax:904-683-0546
Practice Address - Street 1:244 W 54TH ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32208-4602
Practice Address - Country:US
Practice Address - Phone:904-422-6732
Practice Address - Fax:904-683-0546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-26
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL233239251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013931800Medicaid