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Organization
ELITE HOME CARE OF JAX LLC
Active
Organization
ELITE HOME CARE OF JAX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWNDREA THOMAS-GIBSON (CEO/OWNER)
(904) 339-2611
Entity
Organization
Contact information
Practice address
16334 DAWNWOOD CT, JACKSONVILLE, FL 32218-0107
(904) 339-2611
Mailing address
16334 DAWNWOOD CT, JACKSONVILLE, FL 32218-0107
(904) 339-2611
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
NULL
171M00000X
Case Manager/Care Coordinator
—
—
251B00000X
Case Management Agency
—
NULL
251C00000X
Developmentally Disabled Services Day Training Agency
—
NULL
251E00000X
Home Health Agency
Primary
—
NULL
253Z00000X
In Home Supportive Care Agency
—
NULL
261QD1600X
Developmental Disabilities Clinic/Center
—
NULL
311ZA0620X
Adult Care Home Facility
—
NULL
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
NULL
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
NULL
385H00000X
Respite Care
—
NULL
Other
Enumeration date
07/31/2019
Last updated
01/02/2021
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