Provider Demographics
NPI:1225138274
Name:KEYSTONE JJAEP, LLC
Entity Type:Organization
Organization Name:KEYSTONE JJAEP, LLC
Other - Org Name:NUECES
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:HELMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-888-7007
Mailing Address - Street 1:1252 LANTANA ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78407-1112
Mailing Address - Country:US
Mailing Address - Phone:361-888-7007
Mailing Address - Fax:361-888-4477
Practice Address - Street 1:1252 LANTANA ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78407-1112
Practice Address - Country:US
Practice Address - Phone:361-888-7007
Practice Address - Fax:361-888-4477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)