Provider Demographics
NPI:1629023585
Name:JMJ THERAPEA CORPORATION
Entity Type:Organization
Organization Name:JMJ THERAPEA CORPORATION
Other - Org Name:JMJ THERAPEA HOME HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:M
Authorized Official - Last Name:JAOJOCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-843-6485
Mailing Address - Street 1:20955 PATHFINDER RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-4045
Mailing Address - Country:US
Mailing Address - Phone:909-843-6485
Mailing Address - Fax:909-843-6548
Practice Address - Street 1:20955 PATHFINDER RD
Practice Address - Street 2:SUITE 200
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-4045
Practice Address - Country:US
Practice Address - Phone:909-843-6485
Practice Address - Fax:909-843-6548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
058223Medicare UPIN
CA058223Medicare ID - Type UnspecifiedHOME HEALTH