Organization
LIL' MAMA'S TOTAL CARE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YOLANDA DENISE AUSTIN-JAMES (REGIONAL MANAGER/OWNER)
(904) 228-7761
Entity
Organization
Contact information
Practice address
3955 WINDY GALE DR N, JACKSONVILLE, FL 32218-4423
(904) 228-7761
(866) 612-3472
Mailing address
PO BOX 26846, JACKSONVILLE, FL 32226-6846
(904) 228-7761
(866) 612-3472
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
251E00000X
Home Health Agency
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6908918 00
—
FL
Enumeration date
01/12/2006
Last updated
09/29/2011
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