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General NPI Number Information
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NPI Number | 1366224693
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Entity Type | Organization
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Legal Business Name | JH COMMUNITY SERVICES OF IL LLC
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Dates
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Enumeration Date | 10/20/2023
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Last Update Date | 10/20/2023
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Provider Practice Location Address
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Address Line | 4 SHEEP PASTURE LANE
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City | SHELTER ISLAND
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State | NY
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Zip | 11964
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Country | US
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Telephone | 212-321-5113
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Fax |
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Provider Business Mailing Address
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Address Line | 228 PARK AVE S STE 36053
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City | NEW YORK
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State | NY
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Zip | 10003-1502
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Country | US
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Telephone | 212-321-5113
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Fax |
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Authorized Official
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Title or Position | CEO, JUKEBOX HEALTH INC.
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Name | ROMANOS FESSAS
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Credential |
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Telephone | 212-321-5113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171WH0202X
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Taxonomy Name | Home Modifications Contractor
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License Number |
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License Number State |
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