# YKKAEB HEALTH - CARE CENTER INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073085825
- **Authorized official:** LISA MITCHELL CCM (CEO)
- **Authorized official phone:** (904) 203-9258

## Contact information

- **Practice address:** 13245 ATLANTIC BLVD \# 4-208, JACKSONVILLE, FL 32225-7121
- **Practice address phone:** (904) 203-9258
- **Mailing address:** 13245 ATLANTIC BLVD \# 4-208, JACKSONVILLE, FL 32225-7121
- **Mailing address phone:** (904) 203-9258

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | Yes |
| 251E00000X | Home Health Agency | — | NULL | — |
| 374U00000X | Home Health Aide | — | NULL | — |
| 374U00000X | Home Health Aide | — | — | — |

## Other

- **Enumeration date:** 12/18/2018
- **Last updated:** 12/18/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1235553538 | — | FL |