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Individual

LATIA LUMPKIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1001 3RD ST NW, JASPER, FL 32052
(386) 292-6563
Mailing address
PO BOX 1782, JASPER, FL 32052-1782
(386) 292-6563
(866) 462-5823

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
251S00000X
Community/Behavioral Health Agency
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
343900000X
Non-emergency Medical Transport (VAN)
347C00000X
Private Vehicle
372500000X
Chore Provider
372600000X
Adult Companion
373H00000X
Day Training/Habilitation Specialist
3747A0650X
Attendant Care Provider
374J00000X
Doula
374U00000X
Home Health Aide
376J00000X
Homemaker
376K00000X
Nurse's Aide
Primary
113431
FL
385H00000X
Respite Care
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004845300
FL
Enumeration date
11/30/2009
Last updated
01/27/2019
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