Provider Demographics
NPI:1699956557
Name:HOME CARE UNLIMITED, LLC
Entity type:Organization
Organization Name:HOME CARE UNLIMITED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:EDNA
Authorized Official - Middle Name:
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-566-3927
Mailing Address - Street 1:3107 SPRING GLEN RD
Mailing Address - Street 2:SUITE # 208
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-5916
Mailing Address - Country:US
Mailing Address - Phone:904-346-0623
Mailing Address - Fax:904-346-0624
Practice Address - Street 1:3107 SPRING GLEN RD
Practice Address - Street 2:SUITE # 208
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-5916
Practice Address - Country:US
Practice Address - Phone:904-346-0623
Practice Address - Fax:904-346-0624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL230198251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL230198OtherAHCA LICENSE