Organization
MY FATHER'S HOUSE SUPPORT SERVICES LLC
Active
Other names
MY FATHER'S HOUSE SUPPORT SERVICES LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JEMEL A POWELL (OWNER)
(904) 576-5756
Entity
Organization
Contact information
Practice address
1130 W 28TH ST, JACKSONVILLE, FL 32209-4012
(904) 576-5756
Mailing address
1130 W 28TH ST, JACKSONVILLE, FL 32209-4012
(904) 576-5756
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
—
—
251300000X
Local Education Agency (LEA)
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251G00000X
Community Based Hospice Care Agency
—
—
253J00000X
Foster Care Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
385H00000X
Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205402870
—
FL
Enumeration date
04/12/2022
Last updated
04/12/2022
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