# EARTHLY STARS, LLC

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

## Provider details

- **NPI number:** 1861976003
- **Authorized official:** TIFFANY MOSLEY (OWNER/ADMINISTRATOR)
- **Authorized official phone:** (904) 472-5355

## Contact information

- **Practice address:** 9616 WATERSHED DR E, JACKSONVILLE, FL 32220-0905
- **Practice address phone:** (904) 472-5355
- **Mailing address:** 9616 WATERSHED DR E, JACKSONVILLE, FL 32220-0905
- **Mailing address phone:** (904) 472-5355

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |
| 261QD1600X | Developmental Disabilities Clinic/Center | — | NULL | — |
| 385HR2055X | Child Mental Illness Respite Care | — | NULL | — |
| 385HR2060X | Child Intellectual and/or Developmental Disabilities Respite Care | — | NULL | — |

## Other

- **Enumeration date:** 09/24/2018
- **Last updated:** 10/16/2019