MEDICARE: RJ SENIOR CARE

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	:	1851978670
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RJ SENIOR CARE

Provider Business Mailing Address
First Line	:	104 KELLY DR STE B
Second Line	:
City	:	VICTORIA
State	:	TX
Zip	:	77904-1551
Country	:	US
Telephone Number	:	361-433-0330
Fax Number	:	361-333-5030

Provider Business Practice Location Address
First Line	:	104 KELLY DR STE B
Second Line	:
City	:	VICTORIA
State	:	TX
Zip	:	77904-1551
Country	:	US
Telephone Number	:	361-433-0330
Fax Number	:	361-333-5030

Authorized Official
Title or Position	:	OWNER
Name	:	PIETRO JORDAO
Credential	:
Telephone Number	:	361-433-0330

Provider Enumeration Date	:	03/26/2021
Last Update Date	:	03/26/2021

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