NPI 1003200874 · live from the CMS NPI Registry
A Place At Home, LLC
In Home Supportive Care in Jacksonville, FL. National Provider Identifier 1003200874, active.
NPI record
| NPI | 1003200874 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | In Home Supportive Care 253Z00000X |
| Practice location | 4237 Salisbury Rd Ste 305, Jacksonville, FL 32216 |
| Practice phone | 904-539-4688 |
| Mailing address | 11422 Miracle Hills Dr Ste 450, Omaha, NE 68154 |
| Enumerated | March 19, 2015 |
| Last updated | December 9, 2025 |
| Authorized official | Dustin Distefano, Ceo |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Home Health | 251E00000X | HHA201205 (NE) |
| In Home Supportive Care primary | 253Z00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.