MEDICARE: J AND V GROUP

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1245501543
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J AND V GROUP

Provider Business Mailing Address
First Line	:	2331 GUS THOMASSON RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75228-3039
Country	:	US
Telephone Number	:	214-227-9337
Fax Number	:	214-227-8525

Provider Business Practice Location Address
First Line	:	2331 GUS THOMASSON RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75228-3039
Country	:	US
Telephone Number	:	214-227-9337
Fax Number	:	214-227-8525

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. JOY E IGBOKWE
Credential	:
Telephone Number	:	214-227-9337

Provider Enumeration Date	:	01/18/2012
Last Update Date	:	01/18/2012

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