Provider Demographics
NPI:1528410743
Name:JJK ENTERPRISES
Entity Type:Organization
Organization Name:JJK ENTERPRISES
Other - Org Name:HOMEWELL OF NORTHERN COLORADO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:KEMP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-461-4799
Mailing Address - Street 1:1401 S TAFT AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-6962
Mailing Address - Country:US
Mailing Address - Phone:970-461-4799
Mailing Address - Fax:
Practice Address - Street 1:1401 S TAFT AVE STE 207
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-6962
Practice Address - Country:US
Practice Address - Phone:970-461-4799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-12
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO04C452251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health