Healthcare Provider Details

I. General information

NPI: 1770911356
Provider Name (Legal Business Name): JJ&B UNITED, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2013
Last Update Date: 08/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3163 KINGSWOOD CT
MANSFIELD TX
76063-7545
US

IV. Provider business mailing address

PO BOX 151345
ARLINGTON TX
76015-7345
US

V. Phone/Fax

Practice location:
  • Phone: 817-472-1040
  • Fax: 817-549-8539
Mailing address:
  • Phone: 817-472-1040
  • Fax: 817-549-8539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number
License Number State

VIII. Authorized Official

Name: JOANNE JANSZ
Title or Position: CEO/CFO
Credential:
Phone: 817-472-1040