MEDICARE: J&A HOLISTIC SUPPORT CARE PROVIDER

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	:	1437928223
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J&A HOLISTIC SUPPORT CARE PROVIDER

Provider Business Mailing Address
First Line	:	217 TWIN PINES LN
Second Line	:
City	:	FRANKFORT
State	:	KY
Zip	:	40601-7644
Country	:	US
Telephone Number	:	502-418-2257
Fax Number	:

Provider Business Practice Location Address
First Line	:	6911 RICHMOND HWY # 324B
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22306-1842
Country	:	US
Telephone Number	:	502-418-2257
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MRS. ANNA ADECK ESINGILA
Credential	:	RN BSN
Telephone Number	:	502-418-2257

Provider Enumeration Date	:	12/21/2023
Last Update Date	:	12/21/2023

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