Provider Demographics
NPI:1477208254
Name:JERUSALEM HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:JERUSALEM HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARREY
Authorized Official - Middle Name:
Authorized Official - Last Name:ABUNAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-410-7544
Mailing Address - Street 1:1930 GLEN ARBOR DR
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-3205
Mailing Address - Country:US
Mailing Address - Phone:419-410-7544
Mailing Address - Fax:
Practice Address - Street 1:1930 GLEN ARBOR DR
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-3205
Practice Address - Country:US
Practice Address - Phone:419-410-7544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-19
Last Update Date:2022-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care