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General NPI Number Information
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NPI Number | 1700886694
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Entity Type | Organization
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Legal Business Name | JRJS HEALTHCARE OPERATIONS LLC
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Dates
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Enumeration Date | 07/21/2005
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Last Update Date | 01/06/2015
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Provider Practice Location Address
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Address Line | 1501 N DE LEON ST
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City | VICTORIA
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State | TX
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Zip | 77901-5902
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Country | US
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Telephone | 361-582-0602
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Fax | 361-582-0509
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Provider Business Mailing Address
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Address Line | 1501 N DE LEON ST
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City | VICTORIA
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State | TX
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Zip | 77901-5902
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Country | US
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Telephone | 361-582-0602
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Fax | 361-582-0509
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RICHARD LEGGETT
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Credential | D.O.
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Telephone | 361-582-0602
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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 | 005346
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License Number State | TX
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