Provider Demographics
NPI:1417125824
Name:JABA ENTERPRISES INC
Entity Type:Organization
Organization Name:JABA ENTERPRISES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QA MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BERWICK
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCIS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:337-413-1717
Mailing Address - Street 1:PO BOX 227
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:LA
Mailing Address - Zip Code:70538
Mailing Address - Country:US
Mailing Address - Phone:337-413-1717
Mailing Address - Fax:
Practice Address - Street 1:1101 NORTHWEST BLVD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:LA
Practice Address - Zip Code:70538
Practice Address - Country:US
Practice Address - Phone:337-413-1717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JABA ENTERPRISES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1008991Medicaid