Provider Demographics
NPI:1497275994
Name:JJETT HOME HEALTH CARE
Entity Type:Organization
Organization Name:JJETT HOME HEALTH CARE
Other - Org Name:JJETT GROUP LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TANISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-589-8653
Mailing Address - Street 1:11510 WILLOW
Mailing Address - Street 2:
Mailing Address - City:SOUTHGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48195-7316
Mailing Address - Country:US
Mailing Address - Phone:734-833-3700
Mailing Address - Fax:
Practice Address - Street 1:11510 WILLOW
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-7316
Practice Address - Country:US
Practice Address - Phone:734-833-3700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health