Provider Demographics
NPI:1114649225
Name:JAYMANS HOME HEALTHCARE AGENCY LLC
Entity Type:Organization
Organization Name:JAYMANS HOME HEALTHCARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JENEBA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANSARAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-351-3093
Mailing Address - Street 1:7523 LITTLE RIVER TPKE APT 102
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-2931
Mailing Address - Country:US
Mailing Address - Phone:571-351-3093
Mailing Address - Fax:
Practice Address - Street 1:7523 LITTLE RIVER TPKE APT 102
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-2931
Practice Address - Country:US
Practice Address - Phone:571-351-3093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health