Provider Demographics
NPI:1376904854
Name:JOSAJA LLC
Entity Type:Organization
Organization Name:JOSAJA LLC
Other - Org Name:BLUEFIELD CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:STINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-674-3553
Mailing Address - Street 1:3823 NORTHWEST PKWY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-3501
Mailing Address - Country:US
Mailing Address - Phone:214-674-3553
Mailing Address - Fax:
Practice Address - Street 1:3823 NORTHWEST PKWY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-3501
Practice Address - Country:US
Practice Address - Phone:214-674-3553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOSAJA LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-03-11
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health