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General NPI Number Information
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NPI Number | 1316445182
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Entity Type | Organization
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Legal Business Name | EJ2LLC
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Dates
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Enumeration Date | 01/26/2018
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Last Update Date | 01/26/2018
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Provider Practice Location Address
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Address Line | 5021 KNOLL VIEW CIR
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City | HOOVER
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State | AL
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Zip | 35244-8268
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Country | US
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Telephone | 205-602-1506
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Fax |
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Provider Business Mailing Address
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Address Line | 5021 KNOLL VIEW CIR
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City | HOOVER
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State | AL
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Zip | 35244-8268
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT / CEO
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Name | MR. EDWARD JOSEPH SELLECK
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Credential |
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Telephone | 205-602-1506
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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