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Organization

SOURCE COMPANION SERIVCE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RANDE HARRIS (OWNER)
(904) 684-3336
Entity
Organization

Contact information

Practice address
9061 WESTERN WAY UNIT 4, JACKSONVILLE, FL 32256-0380
(904) 684-3336
Mailing address
9061 WESTERN WAY UNIT 4, JACKSONVILLE, FL 32256-0380
(904) 684-3336

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
376J00000X
Homemaker
Primary

Other

Enumeration date
06/23/2026
Last updated
06/23/2026
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