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General NPI Number Information
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NPI Number | 1609609635
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Entity Type | Organization
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Legal Business Name | JNK MANAGEMENT LLC.
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Dates
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Enumeration Date | 08/23/2024
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Last Update Date | 08/23/2024
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Provider Practice Location Address
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Address Line | 10718 S 2420 W
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-8659
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Country | US
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Telephone | 801-694-7071
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Fax |
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Provider Business Mailing Address
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Address Line | 10718 S 2420 W
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-8659
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Country | US
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Telephone | 801-694-7071
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. NICKSON N KASUE
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Credential | DIRECTOR
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Telephone | 801-694-7071
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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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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Taxonomy #3
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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