MEDICARE: P AND AJ S HEALTHCARE LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251E00000X	Home Health Agency
2	251S00000X	Community/Behavioral Health Agency
3	253Z00000X	In Home Supportive Care Agency
4	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility

General Provider Information

NPI Number	:	1295324408
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	P AND AJ S HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	1421 GOODALE AVE UPPR
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43606-4235
Country	:	US
Telephone Number	:	567-202-7808
Fax Number	:

Provider Business Practice Location Address
First Line	:	1421 GOODALE AVE UPPR
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43606-4235
Country	:	US
Telephone Number	:	567-202-7808
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. SUNZARAE JOHNSON
Credential	:
Telephone Number	:	567-202-7808

Provider Enumeration Date	:	01/12/2021
Last Update Date	:	01/12/2021

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