Healthcare Provider Details

I. General information

NPI: 1720470248
Provider Name (Legal Business Name): JMJ HOMEHEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2015
Last Update Date: 09/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 EMERALD TRAIL WAY
HORIZON CITY TX
79928-6474
US

IV. Provider business mailing address

408 EMERALD TRAIL WAY
HORIZON CITY TX
79928-6474
US

V. Phone/Fax

Practice location:
  • Phone: 915-269-4362
  • Fax:
Mailing address:
  • Phone: 915-852-5363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number016631
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MR. JOE ESPINOZA
Title or Position: CFO
Credential:
Phone: 915-269-4362