Provider Demographics
NPI:1407326481
Name:NJS HOME HEALTH LLC
Entity Type:Organization
Organization Name:NJS HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:G
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:520-788-1691
Mailing Address - Street 1:21600 N BRADFORD DR
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85138-9007
Mailing Address - Country:US
Mailing Address - Phone:520-788-1691
Mailing Address - Fax:
Practice Address - Street 1:21600 N BRADFORD DR
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85138-9007
Practice Address - Country:US
Practice Address - Phone:520-788-1691
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-03
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2279H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredHome HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1205306495Medicaid