MEDICARE: JABEZ HEALTHCARE

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

General Provider Information

NPI Number	:	1417773557
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JABEZ HEALTHCARE

Provider Business Mailing Address
First Line	:	1271 GARDEN VILLAGE DR
Second Line	:
City	:	FLORISSANT
State	:	MO
Zip	:	63031-1962
Country	:	US
Telephone Number	:	314-809-0755
Fax Number	:

Provider Business Practice Location Address
First Line	:	1271 GARDEN VILLAGE DR
Second Line	:
City	:	FLORISSANT
State	:	MO
Zip	:	63031-1962
Country	:	US
Telephone Number	:	314-809-0755
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. DONNA LARDGE - MCGEE
Credential	:
Telephone Number	:	469-534-6326

Provider Enumeration Date	:	11/22/2024
Last Update Date	:	11/22/2024

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Directions to “JABEZ HEALTHCARE ” Practice Location

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