Healthcare Provider Details

I. General information

NPI: 1245414556
Provider Name (Legal Business Name): JAYREESE CONTRACTING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2007
Last Update Date: 12/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 POLWANNA RD EXTENSION
STAINT HELENA ISLAND SC
29920-1853
US

IV. Provider business mailing address

PO BOX 1583
SAINT HELENA ISLAND SC
29920-1583
US

V. Phone/Fax

Practice location:
  • Phone: 843-838-3295
  • Fax: 843-838-4766
Mailing address:
  • Phone: 843-838-3295
  • Fax: 843-838-4766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DORA D JAMES
Title or Position: DIRECTOR
Credential: MSW
Phone: 843-838-3295