Provider Demographics
NPI:1508389149
Name:JENNICARE HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:JENNICARE HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:NWOKEJI
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:717-545-4853
Mailing Address - Street 1:4813 JONESTOWN RD STE 205
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-1749
Mailing Address - Country:US
Mailing Address - Phone:717-545-4853
Mailing Address - Fax:717-545-0451
Practice Address - Street 1:4813 JONESTOWN RD STE 205
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-1749
Practice Address - Country:US
Practice Address - Phone:717-545-4853
Practice Address - Fax:717-545-0451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA05120501251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health