Provider Demographics
NPI:1245401074
Name:C&J HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:C&J HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CO OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:JACQUES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-432-5909
Mailing Address - Street 1:506 S HWY 27
Mailing Address - Street 2:SUITE E
Mailing Address - City:MINNEOLA
Mailing Address - State:FL
Mailing Address - Zip Code:34715-2702
Mailing Address - Country:US
Mailing Address - Phone:352-432-5909
Mailing Address - Fax:352-432-5910
Practice Address - Street 1:506 S HWY 27
Practice Address - Street 2:SUITE E
Practice Address - City:MINNEOLA
Practice Address - State:FL
Practice Address - Zip Code:34715-2702
Practice Address - Country:US
Practice Address - Phone:352-432-5909
Practice Address - Fax:352-432-5910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PENDING251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health