Provider Demographics
NPI:1346801867
Name:JRAINTERNATIONALLLC
Entity Type:Organization
Organization Name:JRAINTERNATIONALLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:TYWANDA
Authorized Official - Middle Name:REESE
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-598-4640
Mailing Address - Street 1:16 WACHUSETT ST
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-4741
Mailing Address - Country:US
Mailing Address - Phone:412-598-4640
Mailing Address - Fax:978-560-0606
Practice Address - Street 1:16 WACHUSETT ST
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-4741
Practice Address - Country:US
Practice Address - Phone:412-598-4640
Practice Address - Fax:412-560-0606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA821432646OtherHOME CARE AGENCY