Provider Demographics
NPI:1467762831
Name:JAD HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:JAD HOME CARE SERVICES LLC
Other - Org Name:JAD HOME CARE SERVICES LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DORA
Authorized Official - Middle Name:O
Authorized Official - Last Name:LASHLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-697-1190
Mailing Address - Street 1:2370 HIGHWAY 21
Mailing Address - Street 2:
Mailing Address - City:BELLEVIEW
Mailing Address - State:MO
Mailing Address - Zip Code:63623-6315
Mailing Address - Country:US
Mailing Address - Phone:573-697-1190
Mailing Address - Fax:573-697-1190
Practice Address - Street 1:2370 HIGHWAY 21
Practice Address - Street 2:
Practice Address - City:BELLEVIEW
Practice Address - State:MO
Practice Address - Zip Code:63623-6315
Practice Address - Country:US
Practice Address - Phone:573-697-1190
Practice Address - Fax:573-697-1190
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JAD HOME CARE SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-10-19
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOLC1052915251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health