Provider Demographics
NPI:1093331282
Name:JKH HOME CARE LLC
Entity Type:Organization
Organization Name:JKH HOME CARE LLC
Other - Org Name:ALLHEART SENIOR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAGOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-215-0323
Mailing Address - Street 1:210 S ROCKINGCHAIR RD STE A
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-3441
Mailing Address - Country:US
Mailing Address - Phone:870-215-0323
Mailing Address - Fax:
Practice Address - Street 1:210 S ROCKINGCHAIR RD STE A
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-3441
Practice Address - Country:US
Practice Address - Phone:870-215-0323
Practice Address - Fax:844-293-7809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-23
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR240574732Medicaid
AR242335765Medicaid
AR240579797Medicaid
AR240583757Medicaid