Provider Demographics
NPI:1417598103
Name:JST II, INC
Entity Type:Organization
Organization Name:JST II, INC
Other - Org Name:ANGELS AT HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:GASPAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-254-1234
Mailing Address - Street 1:32781 MIDDLEBELT RD STE G
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-1770
Mailing Address - Country:US
Mailing Address - Phone:248-254-1234
Mailing Address - Fax:248-254-1717
Practice Address - Street 1:32781 MIDDLEBELT RD STE G
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-1770
Practice Address - Country:US
Practice Address - Phone:248-254-1234
Practice Address - Fax:248-254-1717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-03
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care