Healthcare Provider Details
I. General information
NPI: 1730738071
Provider Name (Legal Business Name): JENNY'S CARING HANDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/10/2019
Last Update Date: 09/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8401A W SANDIA CIR SE
ALBUQUERQUE NM
87116-5505
US
IV. Provider business mailing address
8401A W SANDIA CIR SE
ALBUQUERQUE NM
87116-5505
US
V. Phone/Fax
- Phone: 505-750-3758
- Fax:
- Phone: 505-750-3758
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QF0050X |
| Taxonomy | Non-Surgical Family Planning Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
JENNIFER
TEJADA
Title or Position: AUTHORIZED OFFICIAL / OWNER
Credential: LM, CPM
Phone: 480-490-2349