Healthcare Provider Details

I. General information

NPI: 1174853097
Provider Name (Legal Business Name): JKS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2009
Last Update Date: 12/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 BROAD ST SUITE 201
FREEHOLD NJ
07728-1742
US

IV. Provider business mailing address

3 BROAD ST SUITE 201
FREEHOLD NJ
07728-1742
US

V. Phone/Fax

Practice location:
  • Phone: 732-462-5777
  • Fax: 732-462-0577
Mailing address:
  • Phone: 732-462-5777
  • Fax: 732-462-0577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHP0136500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberHP0136500
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberHP0136500
License Number StateNJ

VIII. Authorized Official

Name: MRS. KATHLEEN SANDFORD
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 732-462-5777