Provider Demographics
NPI:1699446468
Name:J & L CART
Entity type:Organization
Organization Name:J & L CART
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANEAN
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-324-8641
Mailing Address - Street 1:9000 E JEFFERSON AVE APT 3-03
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48214-2959
Mailing Address - Country:US
Mailing Address - Phone:248-324-8641
Mailing Address - Fax:
Practice Address - Street 1:9000 E JEFFERSON AVE APT 3-03
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48214-2959
Practice Address - Country:US
Practice Address - Phone:248-324-8641
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI9587925Medicaid