Healthcare Provider Details

I. General information

NPI: 1730023367
Provider Name (Legal Business Name): JOMKO HAUS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 EASTERN AVE
ROCKY MOUNT NC
27801-5856
US

IV. Provider business mailing address

601 EASTERN AVE
ROCKY MOUNT NC
27801-5856
US

V. Phone/Fax

Practice location:
  • Phone: 252-231-1273
  • Fax: 252-231-1273
Mailing address:
  • Phone: 252-231-1273
  • Fax: 252-231-1273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH OJI
Title or Position: CEO
Credential:
Phone: 919-801-0428