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Organization
EXTENDED FAMILY OF NORTH FLORIDA, LLC
Active
Organization
EXTENDED FAMILY OF NORTH FLORIDA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LILY MICHELLE KING LPN (OWNER)
(386) 315-1260
Entity
Organization
Contact information
Practice address
21 BENNETT LN, PALM COAST, FL 32137-8610
(386) 315-1260
(386) 401-2467
Mailing address
PO BOX 350373, PALM COAST, FL 32135-0373
(386) 222-2791
(386) 401-2467
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
NULL
163W00000X
Registered Nurse
—
—
164W00000X
Licensed Practical Nurse
—
NULL
164W00000X
Licensed Practical Nurse
—
—
251E00000X
Home Health Agency
—
NULL
253Z00000X
In Home Supportive Care Agency
Primary
—
NULL
261QD1600X
Developmental Disabilities Clinic/Center
—
NULL
314000000X
Skilled Nursing Facility
—
NULL
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
NULL
320700000X
Physical Disabilities Residential Treatment Facility
—
NULL
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
NULL
347C00000X
Private Vehicle
—
NULL
372600000X
Adult Companion
—
NULL
372600000X
Adult Companion
—
—
3747P1801X
Personal Care Attendant
—
NULL
3747P1801X
Personal Care Attendant
—
—
374U00000X
Home Health Aide
—
NULL
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
NULL
376J00000X
Homemaker
—
—
385H00000X
Respite Care
—
NULL
Other
Enumeration date
08/26/2018
Last updated
07/29/2024
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