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General NPI Number Information
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NPI Number | 1528410743
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Entity Type | Organization
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Legal Business Name | JJK ENTERPRISES
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Dates
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Enumeration Date | 07/12/2016
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Last Update Date | 07/12/2016
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Provider Practice Location Address
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Address Line | 1401 S TAFT AVE STE 207
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City | LOVELAND
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State | CO
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Zip | 80537-6962
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Country | US
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Telephone | 970-461-4799
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Fax |
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Provider Business Mailing Address
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Address Line | 1401 S TAFT AVE STE 207
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City | LOVELAND
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State | CO
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Zip | 80537-6962
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Country | US
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Telephone | 970-461-4799
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOHN KEMP
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Credential |
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Telephone | 970-461-4799
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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 | 04C452
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License Number State | CO
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