Provider Demographics
NPI:1154077386
Name:JL3 ENTERPRISES LLC
Entity Type:Organization
Organization Name:JL3 ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:GASKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-220-2316
Mailing Address - Street 1:4000 MITCHELLVILLE RD STE B430
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-3160
Mailing Address - Country:US
Mailing Address - Phone:240-334-2300
Mailing Address - Fax:240-334-2604
Practice Address - Street 1:4000 MITCHELLVILLE RD STE B430
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3160
Practice Address - Country:US
Practice Address - Phone:240-334-2300
Practice Address - Fax:240-334-2604
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JL3 ENTERPRISES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-25
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty