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Organization

PUDDLE OF HEARTS HOMECARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RAYTONYA FREEMAN (CEO)
(904) 835-0722
Entity
Organization

Contact information

Practice address
7316 WILDER AVE, JACKSONVILLE, FL 32208-4270
(904) 612-9079
Mailing address
7316 WILDER AVE, JACKSONVILLE, FL 32208-4270
(904) 835-0722

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
253Z00000X
In Home Supportive Care Agency
Primary
343900000X
Non-emergency Medical Transport (VAN)
385H00000X
Respite Care
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
385HR2065X
Child Physical Disabilities Respite Care

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
109991500
FL
01
237556
AHCA
FL
01
239897
AHCA
FL
01
240785
AHCA
FL
01
241309
AHCA
FL
01
763
AHCA
FL
Enumeration date
06/22/2021
Last updated
03/23/2026
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