MEDICARE: JGSJ LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	385H00000X	Respite Care
2	251E00000X	Home Health Agency
3	3747A0650X	Attendant Care Provider
4	253Z00000X	In Home Supportive Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427493386
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JGSJ LLC

Provider Business Mailing Address
First Line	:	PO BOX 480036
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-5300
Country	:	US
Telephone Number	:	414-704-9031
Fax Number	:	414-775-0725

Provider Business Practice Location Address
First Line	:	2772 N DR. MARTIN LUTHER KING JR DRIVE
Second Line	:	SUITE 105
City	:	MILWAUKEE
State	:	WI
Zip	:	53212-2312
Country	:	US
Telephone Number	:	414-399-3850
Fax Number	:	414-755-0725

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. GREGORY JOSEPH
Credential	:
Telephone Number	:	704-975-2484

Provider Enumeration Date	:	05/06/2013
Last Update Date	:	04/02/2026

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Directions to “JGSJ LLC ” Practice Location

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