Healthcare Provider Details

I. General information

NPI: 1912653924
Provider Name (Legal Business Name): JAI CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2022
Last Update Date: 02/28/2022
Certification Date: 02/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1869 WOODLAND POINTE DR
NASHVILLE TN
37214-4735
US

IV. Provider business mailing address

PO BOX 17163
NASHVILLE TN
37217-0163
US

V. Phone/Fax

Practice location:
  • Phone: 901-337-5863
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: BRIAN WILSON
Title or Position: CO-OWNER
Credential:
Phone: 901-337-5863