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General NPI Number Information
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NPI Number | 1942665476
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Entity Type | Organization
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Legal Business Name | JCMFB, LLC
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Dates
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Enumeration Date | 12/29/2015
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Last Update Date | 12/29/2015
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Provider Practice Location Address
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Address Line | 22865 LAKE FOREST DR # 212
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City | LAKE FOREST
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State | CA
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Zip | 92630-1605
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Country | US
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Telephone | 949-583-0815
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Fax | 949-484-7312
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Provider Business Mailing Address
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Address Line | 22865 LAKE FOREST DR # 212
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City | LAKE FOREST
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State | CA
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Zip | 92630-1605
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Country | US
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Telephone | 949-583-0815
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Fax | 949-484-7312
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Authorized Official
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Title or Position | CEO
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Name | MRS. JOSEFINA M VIRATA
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Credential |
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Telephone | 714-791-5578
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | CA
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