Provider Demographics
NPI:1487363735
Name:INFINITY CARE SUPPORT SERVICES
Entity type:Organization
Organization Name:INFINITY CARE SUPPORT SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TARKESHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHUMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-570-8601
Mailing Address - Street 1:5310 LENOX AVE STE 22B
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32205-4745
Mailing Address - Country:US
Mailing Address - Phone:904-570-8601
Mailing Address - Fax:
Practice Address - Street 1:5310 LENOX AVE STE 22B
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32205-4745
Practice Address - Country:US
Practice Address - Phone:904-570-8601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-15
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child
No251E00000XAgenciesHome Health