Provider Demographics
NPI:1588956718
Name:JIDLAND HOME HEALTHCARE CORPORATION
Entity type:Organization
Organization Name:JIDLAND HOME HEALTHCARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ISMAIL
Authorized Official - Middle Name:ABDULLE
Authorized Official - Last Name:OSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-370-9564
Mailing Address - Street 1:3565 E SPEEDWAY BLVD STE 171
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-3993
Mailing Address - Country:US
Mailing Address - Phone:520-370-9564
Mailing Address - Fax:520-881-6777
Practice Address - Street 1:3565 E SPEEDWAY BLVD STE 171
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-3993
Practice Address - Country:US
Practice Address - Phone:520-370-9564
Practice Address - Fax:520-881-6777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-05
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health