Provider Demographics
NPI:1225529969
Name:JB HOMECARE
Entity Type:Organization
Organization Name:JB HOMECARE
Other - Org Name:LIFE UNDER THE SON, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JONIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DODGENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-489-6941
Mailing Address - Street 1:2100 WATT AVE #130
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825
Mailing Address - Country:US
Mailing Address - Phone:916-489-6941
Mailing Address - Fax:916-479-6943
Practice Address - Street 1:2100 WATT AVE #130
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825
Practice Address - Country:US
Practice Address - Phone:916-489-6941
Practice Address - Fax:916-479-6943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based