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General NPI Number Information
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NPI Number | 1831576768
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Entity Type | Organization
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Legal Business Name | D & J HOMECARE LLC
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Dates
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Enumeration Date | 04/29/2015
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Last Update Date | 09/22/2015
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Provider Practice Location Address
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Address Line | 1411 DOVER RD
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City | MCPHERSON
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State | KS
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Zip | 67460-1722
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Country | US
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Telephone | 620-718-5047
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Fax |
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Provider Business Mailing Address
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Address Line | 1411 DOVER RD
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City | MCPHERSON
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State | KS
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Zip | 67460-1722
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/DON
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Name | DAWNELLE K ADCOCK
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Credential | RN
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Telephone | 620-718-5047
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | B059006
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License Number State | KS
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