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General NPI Number Information
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NPI Number | 1104701770
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Entity Type | Organization
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Legal Business Name | JMM DANCE CO
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Dates
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Enumeration Date | 08/11/2025
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 440 SAN BENITO ST
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City | HOLLISTER
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State | CA
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Zip | 95023-3953
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Country | US
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Telephone | 408-600-5107
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Fax |
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Provider Business Mailing Address
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Address Line | 1311 AZALEA DR
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City | HOLLISTER
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State | CA
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Zip | 95023-6550
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Country | US
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Telephone | 408-771-1364
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RAYMOND GARCIA
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Credential |
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Telephone | 408-771-1364
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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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 |
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License Number State |
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