Provider Demographics
NPI:1407074503
Name:KENNISE REED JUBILEE RESPITE SERVICES
Entity Type:Organization
Organization Name:KENNISE REED JUBILEE RESPITE SERVICES
Other - Org Name:JUBILEE RESPITE SERVICES INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KENNISE
Authorized Official - Middle Name:W
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:BASW
Authorized Official - Phone:504-368-5336
Mailing Address - Street 1:401 WHITNEY AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-2558
Mailing Address - Country:US
Mailing Address - Phone:504-368-5336
Mailing Address - Fax:504-368-5339
Practice Address - Street 1:401 WHITNEY AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-2558
Practice Address - Country:US
Practice Address - Phone:504-368-5336
Practice Address - Fax:504-368-5339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12080311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home