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General NPI Number Information
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NPI Number | 1477223709
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Entity Type | Organization
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Legal Business Name | JSP ENTERPRISES INC
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Dates
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Enumeration Date | 09/17/2021
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Last Update Date | 09/17/2021
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Provider Practice Location Address
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Address Line | 5651 SW 2ND ST
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City | PLANTATION
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State | FL
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Zip | 33317-3568
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Country | US
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Telephone | 954-993-5286
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Fax |
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Provider Business Mailing Address
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Address Line | 5651 SW 2ND ST
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City | PLANTATION
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State | FL
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Zip | 33317-3568
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Country | US
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Telephone | 954-993-5286
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Fax | 954-999-0675
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. SHALIZ WILLIAMS-PIERRE
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Credential | RN, MSW, CCM
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Telephone | 954-993-5286
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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