Provider Demographics
| NPI: | 1518497114 |
|---|---|
| Name: | JINNAH LIFE CARE COMMUINTY |
| Entity Type: | Organization |
| Organization Name: | JINNAH LIFE CARE COMMUINTY |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CEO |
| Authorized Official - Prefix: | MRS |
| Authorized Official - First Name: | KAMILLIA |
| Authorized Official - Middle Name: | KASANDRA |
| Authorized Official - Last Name: | JEFFERIES |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 239-600-9191 |
| Mailing Address - Street 1: | 4231 TRUMAN DR |
| Mailing Address - Street 2: | |
| Mailing Address - City: | SEFFNER |
| Mailing Address - State: | FL |
| Mailing Address - Zip Code: | 33584-8354 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 239-600-9191 |
| Mailing Address - Fax: | 813-643-0150 |
| Practice Address - Street 1: | 4231 TRUMAN DR |
| Practice Address - Street 2: | |
| Practice Address - City: | SEFFNER |
| Practice Address - State: | FL |
| Practice Address - Zip Code: | 33584 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 239-600-9191 |
| Practice Address - Fax: | 813-643-0150 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2017-06-15 |
| Last Update Date: | 2022-07-21 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 251E00000X | Agencies | Home Health | |
| No | 251C00000X | Agencies | Day Training, Developmentally Disabled Services | |
| No | 253Z00000X | Agencies | In Home Supportive Care | |
| No | 261QD1600X | Ambulatory Health Care Facilities | Clinic/Center | Developmental Disabilities |
| No | 261QH0100X | Ambulatory Health Care Facilities | Clinic/Center | Health Service |
| No | 310400000X | Nursing & Custodial Care Facilities | Assisted Living Facility | |
| No | 3104A0625X | Nursing & Custodial Care Facilities | Assisted Living Facility | Assisted Living, Mental Illness |
| No | 3104A0630X | Nursing & Custodial Care Facilities | Assisted Living Facility | Assisted Living, Behavioral Disturbances |
| No | 310500000X | Nursing & Custodial Care Facilities | Intermediate Care Facility, Mental Illness | |
| No | 311500000X | Nursing & Custodial Care Facilities | Alzheimer Center (Dementia Center) | |
| No | 311Z00000X | Nursing & Custodial Care Facilities | Custodial Care Facility | |
| No | 311ZA0620X | Nursing & Custodial Care Facilities | Custodial Care Facility | Adult Care Home |
| No | 315D00000X | Nursing & Custodial Care Facilities | Hospice, Inpatient | |
| No | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) | |
| No | 385HR2060X | Respite Care Facility | Respite Care | Respite Care, Intellectual and/or Developmental Disabilities, Child |
