Individual provider · Type 1 NPI

Shannon E. Tillman, CMA

Adult Companion · Jacksonville, FL

NPI number 1245965144 Active

Practice location

3104 W 12th St
Jacksonville, FL 32254-1808

Call (413) 686-2639 Map

Fax (904) 212-1996

Mailing address

6501 Arlington Expy Ste B105
Jacksonville, FL 32211-0810

Specialties and licenses

TaxonomyCodeLicense
Homemaker 376J00000X238705 (FL)
Adult Companion Primary 372600000X238705 (FL)

Adult Companion: An individual who provides supervision, socialization, and non-medical care to a functionally impaired adult. Companions may assist or supervise the individual with such tasks as meal preparation, laundry and shopping, but do not perform these activities as discrete services. These services are provided in accordance with a therapeutic goal in the plan of care.

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About NPI 1245965144

Shannon E. Tillman, CMA's National Provider Identifier is 1245965144, issued on Jul 24, 2022. The primary taxonomy on file is Adult Companion (372600000X), and the practice location is in Jacksonville, FL. The record was last updated on Jul 25, 2022.