Healthcare Provider Details

I. General information

NPI: 1871727230
Provider Name (Legal Business Name): JMILL ENTERPRISES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2009
Last Update Date: 04/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3833 FRANKLIN AVE
WACO TX
76710-7345
US

IV. Provider business mailing address

1491 S MAIN ST
BOERNE TX
78006-3303
US

V. Phone/Fax

Practice location:
  • Phone: 254-913-7780
  • Fax:
Mailing address:
  • Phone: 830-331-8496
  • Fax: 830-331-8497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. JON MILLER
Title or Position: OWNER
Credential:
Phone: 830-331-8496