Organization
CBHH ONE LIFE AGENCY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELIA G INUSAH LPN (CEO)
(865) 235-9617
Entity
Organization
Contact information
Practice address
1726 N MAIN ST, JACKSONVILLE, FL 32206-4404
(505) 287-5565
(904) 353-2793
Mailing address
13296 SMITHWICK LN, JACKSONVILLE, FL 32226-0716
(865) 235-9617
(904) 353-2793
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251E00000X
Home Health Agency
Primary
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
10/13/2020
Last updated
10/26/2020
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