# JUDAH IN HOME SUPPORT CARE INC

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

## Provider details

- **NPI number:** 1326572272
- **Authorized official:** MRS. CHARMAINE GAYNOR MUIR (MANAGER OWNER)
- **Authorized official phone:** (772) 203-4762

## Contact information

- **Practice address:** 4812 S FEDERAL HWY \# 1, FORT PIERCE, FL 34982-7078
- **Practice address phone:** (772) 742-8145
- **Practice address fax:** (772) 742-8145
- **Mailing address:** 4812 S US HIGHWAY 1, FORT PIERCE, FL 34982-7078
- **Mailing address phone:** (772) 203-4762

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 017020700 | FL | Yes |

## Other

- **Enumeration date:** 04/18/2017
- **Last updated:** 04/18/2017