Provider Demographics
NPI:1710619556
Name:JIBE HO CORPORATION
Entity Type:Organization
Organization Name:JIBE HO CORPORATION
Other - Org Name:SENIOR HELPERS BURNSVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:SMELA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:952-892-8403
Mailing Address - Street 1:3977 COUNTY ROAD 42
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378-6938
Mailing Address - Country:US
Mailing Address - Phone:952-892-8403
Mailing Address - Fax:952-892-8405
Practice Address - Street 1:3977 COUNTY ROAD 42
Practice Address - Street 2:
Practice Address - City:SAVAGE
Practice Address - State:MN
Practice Address - Zip Code:55378-6938
Practice Address - Country:US
Practice Address - Phone:952-892-8403
Practice Address - Fax:952-892-8405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-29
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care