Provider Demographics
NPI:1538466735
Name:J&B SENIOR AND DISABLED SERVICES
Entity Type:Organization
Organization Name:J&B SENIOR AND DISABLED SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JADE
Authorized Official - Middle Name:ANTIONETTE
Authorized Official - Last Name:FAUS
Authorized Official - Suffix:
Authorized Official - Credentials:PCA
Authorized Official - Phone:432-880-2227
Mailing Address - Street 1:404 E 35TH ST
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79762-7509
Mailing Address - Country:US
Mailing Address - Phone:432-880-2227
Mailing Address - Fax:
Practice Address - Street 1:404 E 35TH ST
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79762-7509
Practice Address - Country:US
Practice Address - Phone:432-880-2227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-24
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service