Healthcare Provider Details

I. General information

NPI: 1578235172
Provider Name (Legal Business Name): BJR CAPITAL INVESTMENTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2021
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2105 VANDALIA ST STE 10
COLLINSVILLE IL
62234-4859
US

IV. Provider business mailing address

2105 VANDALIA ST STE 10
COLLINSVILLE IL
62234-4859
US

V. Phone/Fax

Practice location:
  • Phone: 618-855-9120
  • Fax: 618-855-9138
Mailing address:
  • Phone: 618-855-9120
  • Fax: 618-855-9138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: MR. BRITTON ROBERTSON
Title or Position: OWNER
Credential:
Phone: 618-855-9120