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Organization

TIFFANY'S HOMEMAKER AND COMPANION

Active
Other names
Tiffany's Homemaker And Companion
Organization subpart
No

Provider details

NPI number
Authorized official
TIFFANY MCKENNON (OWNER)
(904) 450-1430
Entity
Organization

Contact information

Practice address
11039 COLONIAL TAVERN LN, JACKSONVILLE, FL 32221-2123
(904) 450-1430
Mailing address
11039 COLONIAL TAVERN LN, JACKSONVILLE, FL 32221-2123
(904) 450-1430

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
251G00000X
Community Based Hospice Care Agency
253Z00000X
In Home Supportive Care Agency
Primary
291U00000X
Clinical Medical Laboratory

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
021497100
FL
Enumeration date
10/22/2019
Last updated
03/28/2022
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