# CBHH ONE LIFE AGENCY LLC

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

## Provider details

- **NPI number:** 1821696899
- **Authorized official:** SHELIA G INUSAH LPN (CEO)
- **Authorized official phone:** (865) 235-9617

## Contact information

- **Practice address:** 1726 N MAIN ST, JACKSONVILLE, FL 32206-4404
- **Practice address phone:** (505) 287-5565
- **Practice address fax:** (904) 353-2793
- **Mailing address:** 13296 SMITHWICK LN, JACKSONVILLE, FL 32226-0716
- **Mailing address phone:** (865) 235-9617
- **Mailing address fax:** (904) 353-2793

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | — |
| 171M00000X | Case Manager/Care Coordinator | — | — | — |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 251J00000X | Nursing Care Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | — |

## Other

- **Enumeration date:** 10/13/2020
- **Last updated:** 10/26/2020