Healthcare Provider Details

I. General information

NPI: 1093628174
Provider Name (Legal Business Name): JEAN CARE FOR HOSPICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2142 N GRANDE VIEW LN
MAYLENE AL
35114-6009
US

IV. Provider business mailing address

2142 N GRANDE VIEW LN
MAYLENE AL
35114-6009
US

V. Phone/Fax

Practice location:
  • Phone: 205-213-1010
  • Fax:
Mailing address:
  • Phone: 205-213-1010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number StateNULL

VIII. Authorized Official

Name: MARIETTA N/A FIELDS
Title or Position: CEO
Credential:
Phone: 205-213-1010