Provider Demographics
NPI:1497041032
Name:J J COMPASSIONATE HOME CARE
Entity Type:Organization
Organization Name:J J COMPASSIONATE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JASMINE
Authorized Official - Middle Name:N
Authorized Official - Last Name:TOLBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-874-5523
Mailing Address - Street 1:PO BOX 3163
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28302-3163
Mailing Address - Country:US
Mailing Address - Phone:910-874-5523
Mailing Address - Fax:
Practice Address - Street 1:111 LAMON ST
Practice Address - Street 2:SUITE 207
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-4901
Practice Address - Country:US
Practice Address - Phone:910-323-8500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization