Provider Demographics
NPI: | 1124219217 |
---|---|
Name: | JHCS INC |
Entity type: | Organization |
Organization Name: | JHCS INC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | MARCIA |
Authorized Official - Middle Name: | D |
Authorized Official - Last Name: | JOHNSON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 718-421-2260 |
Mailing Address - Street 1: | 1460 FLATBUSH AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | BROOKLYN |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 11210-2329 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 718-421-2260 |
Mailing Address - Fax: | 718-421-2264 |
Practice Address - Street 1: | 1460 FLATBUSH AVE |
Practice Address - Street 2: | |
Practice Address - City: | BROOKLYN |
Practice Address - State: | NY |
Practice Address - Zip Code: | 11210-2329 |
Practice Address - Country: | US |
Practice Address - Phone: | 718-421-2260 |
Practice Address - Fax: | 718-421-2264 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-08-05 |
Last Update Date: | 2007-08-05 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NY | 0668L001 | 251J00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251J00000X | Agencies | Nursing Care |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NY | 02864804 | Medicaid |