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General NPI Number Information
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NPI Number | 1952715823
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Entity Type | Organization
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Legal Business Name | CJ HOMECARE, INC.
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Dates
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Enumeration Date | 06/18/2014
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Last Update Date | 06/18/2014
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Provider Practice Location Address
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Address Line | 6236 N HIGHWAY 146 # 11
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City | BAYTOWN
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State | TX
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Zip | 77523-9081
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Country | US
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Telephone | 832-514-6539
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8175
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City | WACO
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State | TX
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Zip | 76714-8175
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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
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Name | BRENT WILSON
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Credential |
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Telephone | 254-744-4277
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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 |
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