Provider Demographics
NPI:1356659130
Name:JBL ENTERPRISES, LLC
Entity Type:Organization
Organization Name:JBL ENTERPRISES, LLC
Other - Org Name:HEART TO HEART
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP, OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:V
Authorized Official - Last Name:LIBASCI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-952-7986
Mailing Address - Street 1:4630 LIPSCOMB ST. NE.
Mailing Address - Street 2:STE. 13
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905
Mailing Address - Country:US
Mailing Address - Phone:321-952-7986
Mailing Address - Fax:321-725-7380
Practice Address - Street 1:4630 LIPSCOMB ST. NE.
Practice Address - Street 2:STE. 13
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905
Practice Address - Country:US
Practice Address - Phone:321-952-7986
Practice Address - Fax:321-725-7380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-15
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF001253Z00000X
253Z00000X, 320600000X, 372600000X, 376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL694340796Medicaid
FL691340798Medicaid