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General NPI Number Information
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NPI Number | 1033719752
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Entity Type | Organization
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Legal Business Name | JSRK HEALTHCARE LLC
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Dates
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Enumeration Date | 10/30/2020
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Last Update Date | 10/30/2020
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Provider Practice Location Address
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Address Line | 14241 FIRESTONE BLVD STE 400
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City | LA MIRADA
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State | CA
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Zip | 90638-5534
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Country | US
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Telephone | 800-988-8593
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Fax |
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Provider Business Mailing Address
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Address Line | 14241 FIRESTONE BLVD STE 400
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City | LA MIRADA
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State | CA
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Zip | 90638-5534
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Country | US
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Telephone | 800-988-8593
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | PALAK CHOPRA
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Credential |
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Telephone | 800-988-8593
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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