Healthcare Provider Details

I. General information

NPI: 1699220483
Provider Name (Legal Business Name): JESUCARE SENIOR SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2016
Last Update Date: 08/21/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1335 WESTBANK EXPY UNIT 813
WESTWEGO LA
70096-5036
US

IV. Provider business mailing address

PO BOX 720409
HOUSTON TX
77272-0409
US

V. Phone/Fax

Practice location:
  • Phone: 504-475-4770
  • Fax: 504-799-2499
Mailing address:
  • Phone: 832-882-1090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. SUSIE JACKSON
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 832-882-1090