Provider Demographics
NPI:1033399779
Name:J&M ADULT HOMECARE
Entity Type:Organization
Organization Name:J&M ADULT HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:MISS
Authorized Official - First Name:JHEANNELL
Authorized Official - Middle Name:ALEISHA
Authorized Official - Last Name:REID
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:845-454-6171
Mailing Address - Street 1:134 INNIS AVE
Mailing Address - Street 2:APARTMENT P09
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-2800
Mailing Address - Country:US
Mailing Address - Phone:845-454-6171
Mailing Address - Fax:845-454-6171
Practice Address - Street 1:134 INNIS AVE
Practice Address - Street 2:APT P09
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-2800
Practice Address - Country:US
Practice Address - Phone:845-454-6171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-09
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY560425-1311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home