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Organization
SIMON COMPANION AND HOMEMAKING
Active
Organization
SIMON COMPANION AND HOMEMAKING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATRALL SIMON (OWNER/OPERATOR)
(904) 508-2687
Entity
Organization
Contact information
Practice address
12458 CONDOR DR, JACKSONVILLE, FL 32223-3711
(904) 508-2687
(904) 374-5457
Mailing address
12458 CONDOR DR, JACKSONVILLE, FL 32223-3711
(904) 508-2687
(904) 374-5457
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
020088900
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001477397
—
FL
Enumeration date
10/03/2017
Last updated
10/03/2017
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