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General NPI Number Information
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NPI Number | 1821234337
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Entity Type | Organization
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Legal Business Name | JEN & C HOME CARE,LLC
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Dates
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Enumeration Date | 01/05/2009
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Last Update Date | 01/05/2009
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Provider Practice Location Address
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Address Line | 905 ARAGONA BLVD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-5301
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Country | US
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Telephone | 757-275-9541
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Fax |
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Provider Business Mailing Address
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Address Line | 905 ARAGONA BLVD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-5301
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Country | US
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Telephone | 757-650-0673
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Fax | 757-333-3874
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Authorized Official
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Title or Position | RESIDENTIAL DIRECTOR
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Name | MS. NARCISA BLANCAFLOR DELA CRUZ
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Credential | REGISTERED NURSE
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Telephone | 757-650-0673
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 1117
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State |
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