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General NPI Number Information
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NPI Number | 1316254964
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Entity Type | Organization
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Legal Business Name | JAZLYN CARES INC
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Dates
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Enumeration Date | 09/02/2010
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Last Update Date | 09/02/2010
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Provider Practice Location Address
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Address Line | 3718 GREEN OAK CT
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City | BALTIMORE
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State | MD
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Zip | 21234-4259
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Country | US
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Telephone | 410-504-3517
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Fax | 443-442-1659
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Provider Business Mailing Address
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Address Line | 3718 GREEN OAK CT
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City | BALTIMORE
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State | MD
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Zip | 21234-4259
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Country | US
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Telephone | 410-504-3517
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Fax | 443-442-1659
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Authorized Official
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Title or Position | PROGRAM ADMINISTRATOR
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Name | MS. HABIBAT JUMOKE ADEWUNI
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Credential |
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Telephone | 410-504-3517
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | R2790R
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License Number State | MD
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