Provider Demographics
NPI:1417493917
Name:JD ENTERPRISE RESOURCES LLC
Entity Type:Organization
Organization Name:JD ENTERPRISE RESOURCES LLC
Other - Org Name:SENIOR HELPERS OF FAIRFAX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:FLETCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-940-1515
Mailing Address - Street 1:10375 DEMOCRACY LN STE A
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-2554
Mailing Address - Country:US
Mailing Address - Phone:703-940-1515
Mailing Address - Fax:703-940-1516
Practice Address - Street 1:10375 DEMOCRACY LN STE A
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2554
Practice Address - Country:US
Practice Address - Phone:703-940-1515
Practice Address - Fax:703-940-1516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-09
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-171200253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care