Healthcare Provider Details

I. General information

NPI: 1558931568
Provider Name (Legal Business Name): J & S ASSISTING LIVING AND CONSULTANT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2021
Last Update Date: 06/30/2021
Certification Date: 06/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1343 JOHNS ST
JENNINGS FL
32053-3097
US

IV. Provider business mailing address

1343 JOHNS ST
JENNINGS FL
32053-3097
US

V. Phone/Fax

Practice location:
  • Phone: 386-938-2751
  • Fax:
Mailing address:
  • Phone: 386-938-2751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. JEREMY GERARD MARSHALL
Title or Position: ADMINISTRATOR
Credential:
Phone: 904-207-4191