Organization
YKKAEB HEALTH - CARE CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA MITCHELL CCM (CEO)
(904) 203-9258
Entity
Organization
Contact information
Practice address
13245 ATLANTIC BLVD # 4-208, JACKSONVILLE, FL 32225-7121
(904) 203-9258
Mailing address
13245 ATLANTIC BLVD # 4-208, JACKSONVILLE, FL 32225-7121
(904) 203-9258
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251E00000X
Home Health Agency
—
—
374U00000X
Home Health Aide
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235553538
—
FL
Enumeration date
12/18/2018
Last updated
12/18/2018
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