Provider Demographics
NPI:1326406091
Name:CALL OF DUTY HOME HEALTHCARE II
Entity Type:Organization
Organization Name:CALL OF DUTY HOME HEALTHCARE II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULLIETTE
Authorized Official - Middle Name:JANERIO
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPN, MHA
Authorized Official - Phone:314-359-8043
Mailing Address - Street 1:3607 KENT SPRINGS CT
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-4213
Mailing Address - Country:US
Mailing Address - Phone:314-359-8043
Mailing Address - Fax:855-387-0488
Practice Address - Street 1:14413 CAPE CHARLES CT
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63034-1759
Practice Address - Country:US
Practice Address - Phone:314-359-8043
Practice Address - Fax:855-387-0488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-09
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health