Healthcare Provider Details

I. General information

NPI: 1437696630
Provider Name (Legal Business Name): JE & JI, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2017
Last Update Date: 12/11/2024
Certification Date: 12/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 SHADELAND AVE
DREXEL HILL PA
19026-2909
US

IV. Provider business mailing address

312 SHADELAND AVE
DREXEL HILL PA
19026-2909
US

V. Phone/Fax

Practice location:
  • Phone: 267-250-8693
  • Fax:
Mailing address:
  • Phone: 267-250-8693
  • Fax: 484-466-4906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: JELEH GBODI
Title or Position: CEO
Credential:
Phone: 267-250-8693