Healthcare Provider Details

I. General information

NPI: 1619883626
Provider Name (Legal Business Name): JCM ENTERPRISE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2078 AUTUMN MOON DR UNIT 1
WINDSOR CO
80550-3716
US

IV. Provider business mailing address

2078 AUTUMN MOON DR UNIT 1
WINDSOR CO
80550-3716
US

V. Phone/Fax

Practice location:
  • Phone: 336-918-3157
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code364SH0200X
TaxonomyHome Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: JAMEKA CHERRI MELTON
Title or Position: OWNER
Credential:
Phone: 336-918-3157