Provider Demographics
NPI:1427836238
Name:JIREH HOME CARE LLC
Entity type:Organization
Organization Name:JIREH HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MANDIP
Authorized Official - Middle Name:
Authorized Official - Last Name:TAKANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-615-8621
Mailing Address - Street 1:570 W DEKALB PIKE APT 302
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-3072
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:570 W DEKALB PIKE APT 302
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-3072
Practice Address - Country:US
Practice Address - Phone:215-645-7104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-21
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care