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General NPI Number Information
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NPI Number | 1518207620
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Entity Type | Organization
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Legal Business Name | TEAM JAYNE, LLC
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Dates
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Enumeration Date | 02/26/2013
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Last Update Date | 02/08/2024
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Provider Practice Location Address
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Address Line | 104 HAMILTON ST
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City | LEXINGTON
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State | SC
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Zip | 29072-2116
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Country | US
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Telephone | 803-661-7557
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Fax | 855-205-4533
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Provider Business Mailing Address
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Address Line | PO BOX 2563
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City | LEXINGTON
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State | SC
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Zip | 29071-2563
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Country | US
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Telephone | 803-661-7557
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Fax | 855-205-4533
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. THOMAS G FALK
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Credential |
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Telephone | 803-661-7557
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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 |
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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