Organization
LEE'S LOVE AND CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEREKIA JOHNSON (OWNER)
(904) 616-8677
Entity
Organization
Contact information
Practice address
8278 GOLDEN BAMBOO DR, JACKSONVILLE, FL 32219-6012
(904) 616-8677
Mailing address
8278 GOLDEN BAMBOO DR, DINSMORE, FL 32219-6012
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115562800
—
FL
Enumeration date
12/01/2022
Last updated
05/16/2024
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