Healthcare Provider Details

I. General information

NPI: 1396047452
Provider Name (Legal Business Name): JAY AND JAY HEALTH CARE AGENCY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2010
Last Update Date: 07/03/2023
Certification Date: 07/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1922 DAWSON ROAD
ALBANY GA
31707
US

IV. Provider business mailing address

1922 DAWSON ROAD P.O. BOX 3108
ALBANY GA
31707
US

V. Phone/Fax

Practice location:
  • Phone: 229-317-2040
  • Fax: 229-317-2044
Mailing address:
  • Phone: 229-317-2040
  • Fax: 229-317-2044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number047-R-0510
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. MARY B JACKSON
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 229-317-2040