Provider Demographics
NPI:1609940410
Name:JEBY HEALTH CARE SERVICES,INC
Entity Type:Organization
Organization Name:JEBY HEALTH CARE SERVICES,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADIMINISRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:EBERE
Authorized Official - Middle Name:FELICIA
Authorized Official - Last Name:AMAECHI-AKUECHIAMA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:281-332-6569
Mailing Address - Street 1:614 W MAIN ST STE D101
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-3771
Mailing Address - Country:US
Mailing Address - Phone:281-332-6569
Mailing Address - Fax:281-332-1076
Practice Address - Street 1:614 W MAIN ST STE D101
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-3729
Practice Address - Country:US
Practice Address - Phone:281-332-6569
Practice Address - Fax:281-332-1076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009291251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001007892Medicaid
TX001010722Medicaid
TX001013066Medicaid
TX157265301Medicaid
TX679176Medicare ID - Type Unspecified