Provider Demographics
NPI:1417408691
Name:C&J HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:C&J HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAME MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ANOWEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-988-8697
Mailing Address - Street 1:3018 HURST GREEN LN
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:TX
Mailing Address - Zip Code:77545-1405
Mailing Address - Country:US
Mailing Address - Phone:240-988-8697
Mailing Address - Fax:
Practice Address - Street 1:3018 HURST GREEN LN
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:TX
Practice Address - Zip Code:77545-1405
Practice Address - Country:US
Practice Address - Phone:240-988-8697
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-21
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities