MEDICARE: JC GLOBAL HEALTH SYSTEMS, LLC

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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1427649938
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JC GLOBAL HEALTH SYSTEMS, LLC

Provider Business Mailing Address
First Line	:	1104 ANDEAN GOOSE WAY
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20774-7130
Country	:	US
Telephone Number	:	202-375-4367
Fax Number	:

Provider Business Practice Location Address
First Line	:	1104 ANDEAN GOOSE WAY
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20774-7130
Country	:	US
Telephone Number	:	202-375-4367
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	MRS. WANDA C CAESAR
Credential	:	FNP
Telephone Number	:	202-375-4367

Provider Enumeration Date	:	01/27/2021
Last Update Date	:	01/27/2021

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