Healthcare Provider Details

I. General information

NPI: 1427203934
Provider Name (Legal Business Name): J&R SENIOR SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2008
Last Update Date: 11/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4010 DUPONT CIRCLE STE #581
LOUISVILLE KY
40207
US

IV. Provider business mailing address

4010 DUPONT CIRCLE STE #581
LOUISVILLE KY
40207
US

V. Phone/Fax

Practice location:
  • Phone: 502-721-1090
  • Fax: 502-897-3334
Mailing address:
  • Phone: 502-721-1090
  • Fax: 502-897-3334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFF J. PERIUS
Title or Position: PRESIDENT
Credential:
Phone: 502-721-1090