Provider Demographics
NPI:1508305848
Name:JERNIGAN'S ADULT DAY CARE
Entity Type:Organization
Organization Name:JERNIGAN'S ADULT DAY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:EVETTE
Authorized Official - Last Name:JERNIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-683-0278
Mailing Address - Street 1:5039 REED RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77033-4000
Mailing Address - Country:US
Mailing Address - Phone:832-683-0278
Mailing Address - Fax:832-804-7421
Practice Address - Street 1:5039 REED RD
Practice Address - Street 2:SUITE 1
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77033-4000
Practice Address - Country:US
Practice Address - Phone:832-683-0278
Practice Address - Fax:832-804-7421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care