Healthcare Provider Details

I. General information

NPI: 1356157093
Provider Name (Legal Business Name): JREAM VET HOUSING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2024
Last Update Date: 12/07/2024
Certification Date: 12/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1824 HONEYDEW CT
OCOEE FL
34761-7705
US

IV. Provider business mailing address

1824 HONEYDEW CT
OCOEE FL
34761-7705
US

V. Phone/Fax

Practice location:
  • Phone: 407-968-7777
  • Fax:
Mailing address:
  • Phone: 407-968-7777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name: JODY PATRICE BAILEY- MASON
Title or Position: OWNER
Credential: NURSE
Phone: 407-968-7777