Provider Demographics
NPI:1154597227
Name:J & J INDEPENDENT LIVING ASSISTANCE
Entity type:Organization
Organization Name:J & J INDEPENDENT LIVING ASSISTANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JODI
Authorized Official - Middle Name:DONE'
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-690-8030
Mailing Address - Street 1:2311 BALSAM DR
Mailing Address - Street 2:H204
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-5924
Mailing Address - Country:US
Mailing Address - Phone:817-690-8030
Mailing Address - Fax:
Practice Address - Street 1:2311 BALSAM DR
Practice Address - Street 2:H204
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006-5924
Practice Address - Country:US
Practice Address - Phone:817-690-8030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health