MEDICARE: JAGS HOME HEALTH CARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	HP0266800	NJ

General Provider Information

NPI Number	:	1295245116
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAGS HOME HEALTH CARE INC

Provider Business Mailing Address
First Line	:	1000 S LENOLA RD STE 102
Second Line	:
City	:	MAPLE SHADE
State	:	NJ
Zip	:	08052-1630
Country	:	US
Telephone Number	:	856-533-0101
Fax Number	:	856-533-0102

Provider Business Practice Location Address
First Line	:	1000 S LENOLA RD STE 102
Second Line	:
City	:	MAPLE SHADE
State	:	NJ
Zip	:	08052-1630
Country	:	US
Telephone Number	:	856-533-0101
Fax Number	:	856-533-0102

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. ADRIENNE BROOKS RIGUEUR
Credential	:	DO
Telephone Number	:	856-533-0101

Provider Enumeration Date	:	10/05/2017
Last Update Date	:	10/05/2017

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