Organization
ADDLIFE CARE CONNECTION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANACE ISAAC LPN (PRESIDENT/CEO)
(904) 293-5395
Entity
Organization
Contact information
Practice address
629 DANIELS ST, HASTINGS, FL 32145-3201
(904) 293-5395
Mailing address
PO BOX 101, HASTINGS, FL 32145-0101
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
—
—
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
04/05/2022
Last updated
04/05/2022
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