=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295960367
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | J & S CARE INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/19/2009
-----------------------------------------------------
Last Update Date | 10/15/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 939 GOINS ROAD
-----------------------------------------------------
City | PEMBROKE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28372-8362
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-521-0040
-----------------------------------------------------
Fax | 910-521-3266
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 941 GOINS RD
-----------------------------------------------------
City | PEMBROKE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28372-8362
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-521-0040
-----------------------------------------------------
Fax | 910-521-3266
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MRS. KAREN HUNT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 910-521-0040
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 310400000X
-----------------------------------------------------
Taxonomy Name | Assisted Living Facility
-----------------------------------------------------
License Number | HAL-078-065
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------