Provider Demographics
NPI:1336675792
Name:JEDCONNECT, LLC
Entity Type:Organization
Organization Name:JEDCONNECT, LLC
Other - Org Name:HOME INSTEAD SENIOR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FRANCHISE OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:3130-645-8475
Mailing Address - Street 1:5601 W SLAUSON AVE
Mailing Address - Street 2:SUITE 255
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-6582
Mailing Address - Country:US
Mailing Address - Phone:310-645-8475
Mailing Address - Fax:310-645-8415
Practice Address - Street 1:5601 W SLAUSON AVE
Practice Address - Street 2:SUITE 255
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6582
Practice Address - Country:US
Practice Address - Phone:310-645-8475
Practice Address - Fax:310-645-8415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-04
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA194700052253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA194700052OtherHOME CARE SERVICES BUREAU