Provider Demographics
NPI:1679845549
Name:JLK HOME CARE, INC
Entity Type:Organization
Organization Name:JLK HOME CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATE
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-893-2001
Mailing Address - Street 1:900 E KAREN AVE
Mailing Address - Street 2:SUITE B210
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109-1264
Mailing Address - Country:US
Mailing Address - Phone:702-893-2001
Mailing Address - Fax:702-369-3334
Practice Address - Street 1:900 E KAREN AVE
Practice Address - Street 2:SUITE B210
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-1264
Practice Address - Country:US
Practice Address - Phone:702-893-2001
Practice Address - Fax:702-369-3334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-07
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5263PCS-3253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV9005054117Medicaid