Provider Demographics
NPI:1376110775
Name:WILLIAMS & CO LLC
Entity Type:Organization
Organization Name:WILLIAMS & CO LLC
Other - Org Name:JABEZ COMPLETE CARE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:DENESE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:702-630-5620
Mailing Address - Street 1:6856 AXIS WEST CIR APT 3302
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32821-6109
Mailing Address - Country:US
Mailing Address - Phone:702-630-5620
Mailing Address - Fax:702-623-7635
Practice Address - Street 1:6856 AXIS WEST CIR APT 3302
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32821-6109
Practice Address - Country:US
Practice Address - Phone:702-623-7635
Practice Address - Fax:702-623-7635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-05
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care