MEDICARE: J&J HOME CARE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	28754	MN

General Provider Information

NPI Number	:	1225470610
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J&J HOME CARE, INC.

Provider Business Mailing Address
First Line	:	8997 HIGHWAY 5
Second Line	:
City	:	LAKE ELMO
State	:	MN
Zip	:	55042-8900
Country	:	US
Telephone Number	:	651-493-1251
Fax Number	:	651-493-6696

Provider Business Practice Location Address
First Line	:	8997 HIGHWAY 5
Second Line	:
City	:	LAKE ELMO
State	:	MN
Zip	:	55042-8900
Country	:	US
Telephone Number	:	651-493-1251
Fax Number	:	651-493-6696

Authorized Official
Title or Position	:	OWNER
Name	:	JULI WALL
Credential	:
Telephone Number	:	651-493-1251

Provider Enumeration Date	:	07/25/2013
Last Update Date	:	07/25/2013

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