Provider Demographics
NPI:1992135255
Name:JPB OMNI ENTERPRISES
Entity type:Organization
Organization Name:JPB OMNI ENTERPRISES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-885-9129
Mailing Address - Street 1:198 W HOBART GAP RD
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-5142
Mailing Address - Country:US
Mailing Address - Phone:877-885-9129
Mailing Address - Fax:
Practice Address - Street 1:198 W HOBART GAP RD
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-5142
Practice Address - Country:US
Practice Address - Phone:877-885-9129
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-22
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0160400251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ12-1276OtherNEW JERSEY GLOBAL OPTIONS