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NPI Code Detail

MEDICARE: J SQUARED, INC.

MEDICARE: J SQUARED, 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
1314000000XSkilled Nursing Facility118223TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801931845
Entity Type Code : Organization
Provider Name (Legal Business Name) : J SQUARED, INC.
Provider Business Mailing Address
First Line : 11913 PASEO DORADO CIR
Second Line :
City : EL PASO
State : TX
Zip : 79936-3785
Country : US
Telephone Number : 915-566-2111
Fax Number : 866-838-4666
Provider Business Practice Location Address
First Line : 2729 PORTER AVE
Second Line :
City : EL PASO
State : TX
Zip : 79930-3625
Country : US
Telephone Number : 915-566-2111
Fax Number : 915-562-6611
Authorized Official
Title or Position : ADMINISTRATOR
Name : DONOVAN J RIVERA
Credential :
Telephone Number : 915-566-2111
Provider Enumeration Date : 02/20/2007
Last Update Date : 04/16/2025

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