Provider Demographics
NPI:1588693428
Name:J & J HOME HEALTH AGENCY, INC
Entity type:Organization
Organization Name:J & J HOME HEALTH AGENCY, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:MOSES
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:817-447-8426
Mailing Address - Street 1:312 OLD HWY 1187
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028
Mailing Address - Country:US
Mailing Address - Phone:817-447-8426
Mailing Address - Fax:817-447-9958
Practice Address - Street 1:1301 LOS EBANOS
Practice Address - Street 2:BLDG A
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520
Practice Address - Country:US
Practice Address - Phone:956-544-5766
Practice Address - Fax:956-504-9680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX006536251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX012570001Medicaid
TX006536OtherHOME HEALTH SERVICES
TX1323870001Medicare NSC