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General NPI Number Information
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NPI Number | 1316258858
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Entity Type | Organization
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Legal Business Name | MAHAFFEY JL ENTERPRISES, INC.
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Dates
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Enumeration Date | 06/30/2010
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Last Update Date | 06/30/2010
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Provider Practice Location Address
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Address Line | 5981 HALEY WAY
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City | FRISCO
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State | TX
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Zip | 75034-4879
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Country | US
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Telephone | 972-523-8658
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Fax |
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Provider Business Mailing Address
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Address Line | 5981 HALEY WAY
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City | FRISCO
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State | TX
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Zip | 75034-4879
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Country | US
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Telephone | 972-523-8658
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JACK L MAHAFFEY
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Credential |
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Telephone | 972-523-8658
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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 | 801255407
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License Number State | TX
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