Provider Demographics
NPI:1326356049
Name:J&J INDEPENDENT LIVING AIDS, LLC
Entity Type:Organization
Organization Name:J&J INDEPENDENT LIVING AIDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ATKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-248-3206
Mailing Address - Street 1:205 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53094-4503
Mailing Address - Country:US
Mailing Address - Phone:920-206-0400
Mailing Address - Fax:920-206-0420
Practice Address - Street 1:205 S 3RD ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:WI
Practice Address - Zip Code:53094-4503
Practice Address - Country:US
Practice Address - Phone:920-206-0400
Practice Address - Fax:920-206-0420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies