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General NPI Number Information
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NPI Number | 1073031746
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Entity Type | Organization
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Legal Business Name | J&K HOME CARE INC.
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Dates
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Enumeration Date | 09/01/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 101 W OTTER RIDGE DR STE A
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City | GOODE
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State | VA
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Zip | 24556-2000
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Country | US
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Telephone | 434-401-9471
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Fax |
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Provider Business Mailing Address
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Address Line | 101 W OTTER RIDGE DR STE A
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City | GOODE
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State | VA
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Zip | 24556-2000
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Country | US
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Telephone | 434-401-9471
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. JOHN WILLIAM MOISA
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Credential |
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Telephone | 434-401-9471
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | HCO-181579
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | HCO-181579
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HCO-181579
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License Number State | VA
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