Provider Demographics
NPI:1558013417
Name:MCJ PARTNERS LLC
Entity Type:Organization
Organization Name:MCJ PARTNERS LLC
Other - Org Name:PATHWAY HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAIMY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-972-6051
Mailing Address - Street 1:PO BOX 10509
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93389-0509
Mailing Address - Country:US
Mailing Address - Phone:661-972-6051
Mailing Address - Fax:
Practice Address - Street 1:410 LANSING DR
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-3156
Practice Address - Country:US
Practice Address - Phone:661-972-4646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-21
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA310400000XOtherSTATE OF CALIFORNIA