Provider Demographics
NPI:1710178090
Name:JAIMEL HEALTH CARE SERVICE LLC
Entity Type:Organization
Organization Name:JAIMEL HEALTH CARE SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:TORAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-780-2968
Mailing Address - Street 1:9950 WESTPARK DR
Mailing Address - Street 2:SUITE 404
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-5138
Mailing Address - Country:US
Mailing Address - Phone:713-780-2968
Mailing Address - Fax:713-780-2936
Practice Address - Street 1:9950 WESTPARK DR
Practice Address - Street 2:SUITE 404
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-5138
Practice Address - Country:US
Practice Address - Phone:713-780-2968
Practice Address - Fax:713-780-2936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX012039251E00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001016373OtherTX DADS - MDCP PROGRAM
TX001020338OtherTX DADS - 24 HR SHARED ATTENDANT CARE PROGRAM
TX001016121OtherTX DADS - CLASS PROGRAM
TX001016372OtherTX DADS - PHC PROGRAM
TX201976201Medicaid
TX74-3198OtherMEDICARE CERTIFICATION # (CCN)