Provider Demographics
NPI:1619130457
Name:JUDAH GLOBAL ENTERPRISES INCORPORATED
Entity Type:Organization
Organization Name:JUDAH GLOBAL ENTERPRISES INCORPORATED
Other - Org Name:PROFESSIONAL CARE HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:EDMONA
Authorized Official - Middle Name:FLORA
Authorized Official - Last Name:LONGSTREET
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:1877-648-5437
Mailing Address - Street 1:16340 LOWER HARBOR RD
Mailing Address - Street 2:#213
Mailing Address - City:BROOKINGS
Mailing Address - State:OR
Mailing Address - Zip Code:97415-8303
Mailing Address - Country:US
Mailing Address - Phone:877-648-5437
Mailing Address - Fax:866-267-3872
Practice Address - Street 1:16340 LOWER HARBOR RD
Practice Address - Street 2:#213
Practice Address - City:BROOKINGS
Practice Address - State:OR
Practice Address - Zip Code:97415-8303
Practice Address - Country:US
Practice Address - Phone:877-648-5437
Practice Address - Fax:866-267-3872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2008N0774251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care