# JEREMIAH'S WALK HOME & HEALTH AGENCY, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1114744976
- **Authorized official:** MRS. GAIL NELSON-LEWIS RN (OWNER)
- **Authorized official phone:** (904) 400-9864

## Contact information

- **Practice address:** 3757 LONGLEAF FOREST LN, JACKSONVILLE, FL 32210-9100
- **Practice address phone:** (904) 300-3933
- **Mailing address:** 3757 LONGLEAF FOREST LN, JACKSONVILLE, FL 32210-9100
- **Mailing address phone:** (904) 300-3933

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251C00000X | Developmentally Disabled Services Day Training Agency | — | NULL | — |
| 251J00000X | Nursing Care Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | — |
| 310400000X | Assisted Living Facility | — | NULL | — |
| 311Z00000X | Custodial Care Facility | — | — | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |
| 347C00000X | Private Vehicle | — | NULL | — |
| 372600000X | Adult Companion | — | NULL | — |
| 385H00000X | Respite Care | — | NULL | — |

## Other

- **Enumeration date:** 09/23/2024
- **Last updated:** 08/20/2026