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General NPI Number Information
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NPI Number | 1588956718
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Entity Type | Organization
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Legal Business Name | JIDLAND HOME HEALTHCARE CORPORATION
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Dates
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Enumeration Date | 05/05/2011
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Last Update Date | 05/05/2011
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Provider Practice Location Address
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Address Line | 3565 E SPEEDWAY BLVD STE 171
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City | TUCSON
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State | AZ
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Zip | 85716-3993
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Country | US
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Telephone | 520-370-9564
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Fax | 520-881-6777
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Provider Business Mailing Address
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Address Line | 3565 E SPEEDWAY BLVD STE 171
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City | TUCSON
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State | AZ
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Zip | 85716-3993
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Country | US
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Telephone | 520-370-9564
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Fax | 520-881-6777
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Authorized Official
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Title or Position | OWNER
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Name | ISMAIL ABDULLE OSMAN
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Credential |
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Telephone | 520-370-9564
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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 |
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