Provider Demographics
NPI:1629412911
Name:JJ MOBILITY
Entity Type:Organization
Organization Name:JJ MOBILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:JABLONSKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-380-8632
Mailing Address - Street 1:W8660 174TH AVE
Mailing Address - Street 2:
Mailing Address - City:HAGER CITY
Mailing Address - State:WI
Mailing Address - Zip Code:54014-8140
Mailing Address - Country:US
Mailing Address - Phone:651-380-8632
Mailing Address - Fax:
Practice Address - Street 1:W8660 174TH AVE
Practice Address - Street 2:
Practice Address - City:HAGER CITY
Practice Address - State:WI
Practice Address - Zip Code:54014-8140
Practice Address - Country:US
Practice Address - Phone:651-380-8632
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-17
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
343900000X343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)