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MY FATHER'S HOUSE SUPPORT SERVICES LLC NPI 1932841590


NPI Information

NPI: 1932841590
Provider Name: MY FATHER'S HOUSE SUPPORT SERVICES LLC
Classification: Day Training, Developmentally Disabled Services - 251C00000X
Entity Type: Organization
Address:
1130 W 28TH ST
JACKSONVILLE, FL
ZIP 32209
Phone: (904) 576-5756
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MY FATHER'S HOUSE SUPPORT SERVICES LLC is a day training developmentally disabled services in Jacksonville, FL. The provider is these agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. MY FATHER'S HOUSE SUPPORT SERVICES LLC NPI is 1932841590. The provider is registered as an organization entity type.

The provider's business location address is:

1130 W 28TH ST
JACKSONVILLE, FL
ZIP 32209-012
Phone: (904) 576-5756

The provider's authorized official is Jemel A Powell .
The authorized official title is Owner and has the following contact phone number (904) 576-5756.

The enumeration date for this NPI number is 4/12/2022 and was last updated on 4/12/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1177F00000XLodgingNo
2251300000XLocal Education Agency (LEA)No
3251G00000XHospice Care, Community BasedNo
4253J00000XFoster Care AgencyNo
5261QA0600XClinic/CenterAdult Day CareNo
6261QD1600XClinic/CenterDevelopmental DisabilitiesNo
7385H00000XRespite CareNo
8385HR2060XRespite CareRespite Care, Intellectual and/or Developmental DisabilitiesNo
9251C00000XDay Training, Developmentally Disabled ServicesYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11205402870MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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