Provider Demographics
NPI:1639202666
Name:JCP&P HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:JCP&P HEALTHCARE SERVICES INC
Other - Org Name:JCP&P HOME HEALTHCARE AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:NNALU
Authorized Official - Last Name:EKWONYE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:214-638-4500
Mailing Address - Street 1:1003 WESTMINISTER AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-4458
Mailing Address - Country:US
Mailing Address - Phone:214-289-8627
Mailing Address - Fax:214-399-4356
Practice Address - Street 1:3605 BROADWAY BLVD STE B
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-1647
Practice Address - Country:US
Practice Address - Phone:214-638-4500
Practice Address - Fax:214-399-4356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009658251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX677877Medicare ID - Type UnspecifiedMEDICARE ID #