Provider Demographics
NPI:1053010884
Name:CARTER'S COMPETENT CARE STAFFING AGENCY, LLC
Entity type:Organization
Organization Name:CARTER'S COMPETENT CARE STAFFING AGENCY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BLENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:386-361-2328
Mailing Address - Street 1:219 SE JEREMY PL
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32025-3901
Mailing Address - Country:US
Mailing Address - Phone:386-232-8241
Mailing Address - Fax:386-381-1099
Practice Address - Street 1:678 SE BAYA DR
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-6038
Practice Address - Country:US
Practice Address - Phone:386-232-8241
Practice Address - Fax:386-381-1099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-01
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care