Healthcare Provider Details

I. General information

NPI: 1275271546
Provider Name (Legal Business Name): JMJS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2022
Last Update Date: 05/25/2022
Certification Date: 05/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10351 BALBOA BLVD
GRANADA HILLS CA
91344-7318
US

IV. Provider business mailing address

10351 BALBOA BLVD
GRANADA HILLS CA
91344-7318
US

V. Phone/Fax

Practice location:
  • Phone: 747-294-8301
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STEVE KIM
Title or Position: PRESIDENT
Credential:
Phone: 747-294-8301