Provider Demographics
NPI:1558901231
Name:SJ HANDS ON HEALTHCARE LLC
Entity Type:Organization
Organization Name:SJ HANDS ON HEALTHCARE LLC
Other - Org Name:SJ HANDS ON HEALTHCARE LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:JAZMINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPRUILL
Authorized Official - Suffix:
Authorized Official - Credentials:PCA
Authorized Official - Phone:757-756-5253
Mailing Address - Street 1:900 GRANBY ST STE 205
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510-2503
Mailing Address - Country:US
Mailing Address - Phone:757-756-5253
Mailing Address - Fax:
Practice Address - Street 1:1129 LOUISA ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23523-1417
Practice Address - Country:US
Practice Address - Phone:757-386-0805
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-10
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health