Organization
SHIRLEY WILSON HEAVENLY HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHIRLEY CRAWFORD WILSON OWNER (OWNER)
(904) 487-3949
Entity
Organization
Contact information
Practice address
5105 BENNING RD, JACKSONVILLE, FL 32254-3610
(904) 667-7962
(904) 580-5805
Mailing address
5105 BENNING RD, JACKSONVILLE, FL 32254-3610
(904) 487-3949
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
04/21/2022
Last updated
04/21/2022
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