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General NPI Number Information
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NPI Number | 1588298863
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Entity Type | Organization
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Legal Business Name | JAYCEE'S HOME CARE
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Dates
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Enumeration Date | 02/26/2020
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Last Update Date | 02/26/2020
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Provider Practice Location Address
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Address Line | 5710 SIX FORKS RD STE 201
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City | RALEIGH
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State | NC
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Zip | 27609-8617
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Country | US
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Telephone | 919-862-4626
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Fax |
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Provider Business Mailing Address
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Address Line | 5710 SIX FORKS RD STE 201
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City | RALEIGH
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State | NC
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Zip | 27609-8617
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Country | US
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Telephone | 919-862-4626
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JAYCEE JOHNSON
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Credential |
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Telephone | 919-862-4625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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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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