Provider Demographics
NPI:1104472224
Name:JACE INC.
Entity type:Organization
Organization Name:JACE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:TEMIDAYO
Authorized Official - Middle Name:
Authorized Official - Last Name:AKINSELURE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-277-2814
Mailing Address - Street 1:14005 DUNWOOD VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-1244
Mailing Address - Country:US
Mailing Address - Phone:240-277-2814
Mailing Address - Fax:240-334-2186
Practice Address - Street 1:14005 DUNWOOD VALLEY DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-1244
Practice Address - Country:US
Practice Address - Phone:240-277-2814
Practice Address - Fax:240-334-2186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home