Healthcare Provider Details

I. General information

NPI: 1770573560
Provider Name (Legal Business Name): JML CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

184 TER HEUN DR
FALMOUTH MA
02540-2503
US

IV. Provider business mailing address

184 TER HEUN DR
FALMOUTH MA
02540-2503
US

V. Phone/Fax

Practice location:
  • Phone: 508-457-4621
  • Fax: 508-457-1218
Mailing address:
  • Phone: 508-457-4621
  • Fax: 508-457-1218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number0917
License Number StateMA

VIII. Authorized Official

Name: MR. CHARLES PETERMAN JR
Title or Position: CEO
Credential:
Phone: 508-457-4621