Organization
FAMILY LIFE CARE, INC.
Active
Parent organization
FAMILY LIFE CARE, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
FAMILY LIFE CARE, INC.
Authorized official
DAVID MCMULLEN (CEO)
(904) 579-1581
Entity
Organization
Contact information
Practice address
406 OHIO AVE S, LIVE OAK, FL 32064-3218
(386) 364-5515
(386) 364-5648
Mailing address
555 WELLS RD, ORANGE PARK, FL 32073-2923
(904) 579-1581
(904) 375-1673
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009916900
—
FL
01
—
299992645
HOME HEALTH AGENCY LICENSE
FL
Enumeration date
07/19/2019
Last updated
07/20/2020
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