Provider Demographics
NPI:1497909972
Name:JK4 ENTERPRISES, INC.
Entity Type:Organization
Organization Name:JK4 ENTERPRISES, INC.
Other - Org Name:VISITING ANGELS DETROIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:KENYON
Authorized Official - Last Name:STALLINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-272-9401
Mailing Address - Street 1:8940 WORMER
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48239-1230
Mailing Address - Country:US
Mailing Address - Phone:313-272-9401
Mailing Address - Fax:313-272-9402
Practice Address - Street 1:2727 2ND AVE
Practice Address - Street 2:SUITE 123
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2658
Practice Address - Country:US
Practice Address - Phone:313-272-9401
Practice Address - Fax:313-272-9402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty