MEDICARE: J & M HOME CARE 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1821872755
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J & M HOME CARE LLC

Provider Business Mailing Address
First Line	:	1517 WADSWORTH AVE
Second Line	:
City	:	SAGINAW
State	:	MI
Zip	:	48601-1624
Country	:	US
Telephone Number	:	989-522-0764
Fax Number	:

Provider Business Practice Location Address
First Line	:	1517 WADSWORTH AVE
Second Line	:
City	:	SAGINAW
State	:	MI
Zip	:	48601-1624
Country	:	US
Telephone Number	:	989-522-0764
Fax Number	:

Authorized Official
Title or Position	:	BOSS LADY
Name	:	JAMISE MITCHELL
Credential	:
Telephone Number	:	989-522-0764

Provider Enumeration Date	:	08/22/2023
Last Update Date	:	08/22/2023

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