Healthcare Provider Details

I. General information

NPI: 1326847518
Provider Name (Legal Business Name): JBB HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2025
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7832 E LELAND CIR
MESA AZ
85207-2128
US

IV. Provider business mailing address

7832 E LELAND CIR
MESA AZ
85207-2128
US

V. Phone/Fax

Practice location:
  • Phone: 602-782-0216
  • Fax:
Mailing address:
  • Phone: 602-782-0216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: VALENA JORDAN
Title or Position: ADMINISTRATIVE OFFICE MANAGER
Credential:
Phone: 602-782-0216