Healthcare Provider Details

I. General information

NPI: 1790508695
Provider Name (Legal Business Name): JEVS CARE AT HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2024
Last Update Date: 11/07/2024
Certification Date: 11/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1404 FORREST AVE STE 2B
DOVER DE
19904-3478
US

IV. Provider business mailing address

9350 ASHTON RD
PHILADELPHIA PA
19114-3400
US

V. Phone/Fax

Practice location:
  • Phone: 302-985-5580
  • Fax: 302-985-5580
Mailing address:
  • Phone: 267-835-4682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: WALESKA MALDONADO
Title or Position: CEO
Credential:
Phone: 215-718-4283