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General NPI Number Information
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NPI Number | 1215825807
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Entity Type | Organization
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Legal Business Name | JJBP, LLC
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Dates
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Enumeration Date | 06/24/2025
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 414 N WILSON ST STE 4
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City | VINITA
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State | OK
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Zip | 74301-2420
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Country | US
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Telephone | 539-257-9905
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Fax | 539-257-9995
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Provider Business Mailing Address
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Address Line | 9500 N 129TH EAST AVE STE 200
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City | OWASSO
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State | OK
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Zip | 74055-5376
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Country | US
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Telephone | 918-645-0986
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Fax |
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | ROBERT MICHAEL BOYD
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Credential |
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Telephone | 918-645-0986
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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 |
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License Number State |
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