Provider Demographics
NPI:1033894118
Name:JAY T HOMECARE SERVICES LLC
Entity Type:Organization
Organization Name:JAY T HOMECARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:TANIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHURN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-324-9261
Mailing Address - Street 1:12904 CHRISTINE AVE
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44105-7036
Mailing Address - Country:US
Mailing Address - Phone:216-324-9261
Mailing Address - Fax:
Practice Address - Street 1:12904 CHRISTINE AVE
Practice Address - Street 2:
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44105-7036
Practice Address - Country:US
Practice Address - Phone:216-324-9261
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty