=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699081513
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JST HEALTHCARE SERVICES,INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/30/2010
-----------------------------------------------------
Last Update Date | 07/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 321 ELMWOOD DR N/A
-----------------------------------------------------
City | GARLAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75043-3327
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-556-5858
-----------------------------------------------------
Fax | 972-240-2843
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 321 ELMWOOD DR N/A
-----------------------------------------------------
City | GARLAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75043-3327
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-556-5858
-----------------------------------------------------
Fax | 972-240-2843
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR/CEO
-----------------------------------------------------
Name | MR. STEPHEN E ORIABURE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 469-556-5858
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------