Provider Demographics
NPI:1275060022
Name:JD SENIOR CARE, INC
Entity Type:Organization
Organization Name:JD SENIOR CARE, INC
Other - Org Name:HOME INSTEAD SENIOR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:TERIANN
Authorized Official - Middle Name:
Authorized Official - Last Name:DROBNICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-980-8538
Mailing Address - Street 1:708 ERIE AVE STE 204
Mailing Address - Street 2:HOME INSTEAD SENIOR CARE
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-4060
Mailing Address - Country:US
Mailing Address - Phone:920-803-0188
Mailing Address - Fax:
Practice Address - Street 1:708 ERIE AVE STE 204
Practice Address - Street 2:HOME INSTEAD SENIOR CARE
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-4060
Practice Address - Country:US
Practice Address - Phone:920-803-0188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care