Provider Demographics
NPI:1316102908
Name:JACY'S HOME HEALTHCARE, PLUS INC.
Entity type:Organization
Organization Name:JACY'S HOME HEALTHCARE, PLUS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:IYIAKIMO
Authorized Official - Last Name:OKAFOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-350-6660
Mailing Address - Street 1:2639 WALNUT HILL LN
Mailing Address - Street 2:STE 232
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-5650
Mailing Address - Country:US
Mailing Address - Phone:214-350-6660
Mailing Address - Fax:214-350-6662
Practice Address - Street 1:2639 WALNUT HILL LN
Practice Address - Street 2:STE 232
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75229-5650
Practice Address - Country:US
Practice Address - Phone:214-350-6660
Practice Address - Fax:214-350-6662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008565251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health