Provider Demographics
NPI:1114544467
Name:CJ'S HOME CARE LLC
Entity Type:Organization
Organization Name:CJ'S HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CURLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON-DARDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-723-1314
Mailing Address - Street 1:6034 CHESTER AVE STE 105A
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-2237
Mailing Address - Country:US
Mailing Address - Phone:904-307-3895
Mailing Address - Fax:
Practice Address - Street 1:6034 CHESTER AVE STE 105A
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-2237
Practice Address - Country:US
Practice Address - Phone:904-307-3895
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-02
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care