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PHENOMENAL HEALTHCARE LLC NPI 1023603503


NPI Information

NPI: 1023603503
Provider Name: PHENOMENAL HEALTHCARE, LLC

Doing Business As: HOME CARE FOR THE 21ST CENTURY- JACKSONVILLE

Classification: In Home Supportive Care - 253Z00000X
Entity Type: Organization

CLIA Number: 10D2257610

Address:
6815 ATLANTIC BLVD STE 3
JACKSONVILLE, FL
ZIP 32211
Phone: (904) 438-5837
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PHENOMENAL HEALTHCARE, LLC is an in home supportive care in Jacksonville, FL. The provider is an In Home Supportive Care Agency provides services in the patient's home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves. PHENOMENAL HEALTHCARE, LLC NPI is 1023603503. The provider is registered as an organization entity type.
The provider Is Doing Business As Home Care For The 21st Century- Jacksonville.

The provider's business location address is:

6815 ATLANTIC BLVD STE 3
JACKSONVILLE, FL
ZIP 32211-764
Phone: (904) 438-5837

The provider's authorized official is Marlena Ellis .
The authorized official title is President/treasurer and has the following contact phone number (904) 438-5837.

The CLIA number assigned to this NPI record is 10D2257610 - home health agency with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/5/2021 and was last updated on 3/8/2022.


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
1251E00000XHome HealthNo
2253Z00000XIn Home Supportive CareYes

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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