Provider Demographics
NPI:1073031746
Name:J&K HOME CARE INC.
Entity Type:Organization
Organization Name:J&K HOME CARE INC.
Other - Org Name:ACTI-KARE RESPONSIVE IN-HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:MOISA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-401-9471
Mailing Address - Street 1:101 W OTTER RIDGE DR STE A
Mailing Address - Street 2:
Mailing Address - City:GOODE
Mailing Address - State:VA
Mailing Address - Zip Code:24556-2000
Mailing Address - Country:US
Mailing Address - Phone:434-401-9471
Mailing Address - Fax:
Practice Address - Street 1:101 W OTTER RIDGE DR STE A
Practice Address - Street 2:
Practice Address - City:GOODE
Practice Address - State:VA
Practice Address - Zip Code:24556-2000
Practice Address - Country:US
Practice Address - Phone:434-401-9471
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-181579251E00000X, 253Z00000X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAHCO-181579OtherHOME CARE LICENSE