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Organization
PRUITTHEALTH HOME HEALTH, INC.
Active
Organization
PRUITTHEALTH HOME HEALTH, INC.
Active
Other names
PruittHealth @ Home Jacksonville
Organization subpart
No
Provider details
NPI number
Authorized official
LYNETHIA NYTONYA HOLLEY (PROVIDER ENROLLMENT SPECIALIST)
(786) 296-0751
Entity
Organization
Contact information
Practice address
4250 LAKESIDE DR, JACKSONVILLE, FL 32210-3358
(833) 679-5232
Mailing address
1626 JEURGENS CT, NORCROSS, GA 30093-2219
(678) 296-0751
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
12/02/2022
Last updated
10/23/2025
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