Healthcare Provider Details

I. General information

NPI: 1659108124
Provider Name (Legal Business Name): JESTINAS ADULT DAY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2024
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 OAKMONT DR
CONROE TX
77301-3246
US

IV. Provider business mailing address

116 OAKMONT DR
CONROE TX
77301-3246
US

V. Phone/Fax

Practice location:
  • Phone: 281-939-9401
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TRACEY-ANN PINNOCK-GREEN
Title or Position: MANAGER
Credential:
Phone: 281-939-9401