Organization
HAVE FAITH SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARINESA POKE (PRESIDENT)
(904) 482-9826
Entity
Organization
Contact information
Practice address
112 LANE AVE S # 5, JACKSONVILLE, FL 32254-3524
(904) 382-9826
Mailing address
2276 CHEROKEE COVE TRL, JACKSONVILLE, FL 32221-4906
(904) 382-9826
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002176300
—
FL
Enumeration date
08/27/2014
Last updated
08/27/2014
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