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Organization
FOREST LANE HEALTHCARE LLC
Active
Organization
FOREST LANE HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAMOYA DAVIS (CEO)
(904) 445-0261
Entity
Organization
Contact information
Practice address
1616 CONCIERGE BLVD STE 103, DAYTONA BEACH, FL 32117-7159
(386) 271-2753
Mailing address
818 FOREST LN, DAYTONA BEACH, FL 32114-1916
(904) 445-0261
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
—
NULL
251E00000X
Home Health Agency
Primary
—
NULL
251F00000X
Home Infusion Agency
—
NULL
251G00000X
Community Based Hospice Care Agency
—
NULL
251J00000X
Nursing Care Agency
—
NULL
332U00000X
Home Delivered Meals
—
NULL
343900000X
Non-emergency Medical Transport (VAN)
—
NULL
347C00000X
Private Vehicle
—
NULL
376K00000X
Nurse's Aide
—
NULL
Other
Enumeration date
05/04/2024
Last updated
05/04/2024
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