Provider Demographics
NPI:1215939491
Name:JONCO, INC.
Entity type:Organization
Organization Name:JONCO, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:SANGSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-534-0150
Mailing Address - Street 1:1202 WEISS ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-5471
Mailing Address - Country:US
Mailing Address - Phone:989-754-1419
Mailing Address - Fax:989-754-4805
Practice Address - Street 1:1202 WEISS ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-5471
Practice Address - Country:US
Practice Address - Phone:989-754-1419
Practice Address - Fax:989-754-4805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI734050313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI734050Medicaid
MI734050Medicaid