Organization
MY FATHER'S HOUSE SUPPORT SERVICES LLC
Active
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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