Provider Demographics
NPI:1992077655
Name:JRC VENTURES DBA BRIGHTSTAR OF CHATTANOOGA
Entity type:Organization
Organization Name:JRC VENTURES DBA BRIGHTSTAR OF CHATTANOOGA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JACQUE
Authorized Official - Middle Name:RODERICK
Authorized Official - Last Name:COLLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-296-6640
Mailing Address - Street 1:117 NOWLIN LN STE 200
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-7320
Mailing Address - Country:US
Mailing Address - Phone:423-296-6640
Mailing Address - Fax:423-296-6643
Practice Address - Street 1:117 NOWLIN LN STE 200
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-7320
Practice Address - Country:US
Practice Address - Phone:423-296-6640
Practice Address - Fax:423-296-6643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-27
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNI000000010208253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care