Organization
SHEANAS CARE SUPPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYSHEANA M PETERSON (OWNER)
(904) 899-2288
Entity
Organization
Contact information
Practice address
12276 SAN JOSE BLVD STE 718-10, JACKSONVILLE, FL 32223-8628
(833) 217-9523
(904) 799-6564
Mailing address
12276 SAN JOSE BLVD STE 718-10, JACKSONVILLE, FL 32223-8628
(833) 217-9523
(904) 799-6564
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
07/05/2021
Last updated
03/13/2026
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