Provider Demographics
NPI:1386018489
Name:JUMPING LILIES HOME CARE, LLC
Entity Type:Organization
Organization Name:JUMPING LILIES HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:214-493-3614
Mailing Address - Street 1:8700 STONEBROOK PKWY UNIT 2741
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-6199
Mailing Address - Country:US
Mailing Address - Phone:214-267-8816
Mailing Address - Fax:
Practice Address - Street 1:8700 STONEBROOK PKWY UNIT 2741
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-6199
Practice Address - Country:US
Practice Address - Phone:214-267-8816
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility