Organization
EXTENDED FAMILY OF NORTH FLORIDA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LILY MICHELLE KING LPN (OWNER)
(386) 315-1260
Entity
Organization
Contact information
Practice address
21 BENNETT LN, PALM COAST, FL 32137-8610
(386) 315-1260
(386) 401-2467
Mailing address
PO BOX 350373, PALM COAST, FL 32135-0373
(386) 222-2791
(386) 401-2467
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
164W00000X
Licensed Practical Nurse
—
—
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
314000000X
Skilled Nursing Facility
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320700000X
Physical Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
347C00000X
Private Vehicle
—
—
372600000X
Adult Companion
—
—
3747P1801X
Personal Care Attendant
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
08/26/2018
Last updated
07/29/2024
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