Organization
SENIORS PARADISE HOMECARE AGENCY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIONNE SAMAROO (OWNER)
(904) 704-3901
Entity
Organization
Contact information
Practice address
12373 HAGAN CREEK DR, JACKSONVILLE, FL 32218-8319
(904) 704-3901
Mailing address
12373 HAGAN CREEK DR, JACKSONVILLE, FL 32218-8319
(904) 704-3901
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108011000
—
FL
Enumeration date
09/17/2020
Last updated
03/13/2024
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