Healthcare Provider Details

I. General information

NPI: 1316862188
Provider Name (Legal Business Name): JRK TRUSTED HOME SUPPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 OSGOOD AVE
LOWELL MA
01850-1116
US

IV. Provider business mailing address

5 OSGOOD AVE
LOWELL MA
01850-1116
US

V. Phone/Fax

Practice location:
  • Phone: 857-856-0245
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JOELYN K GBUSSEH
Title or Position: OWNER
Credential:
Phone: 857-856-0245