Provider Demographics
NPI:1811017080
Name:JLJ ENTERPRISES INC
Entity Type:Organization
Organization Name:JLJ ENTERPRISES INC
Other - Org Name:HEAVEN SENT HOME CARE SERVICES INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JODY
Authorized Official - Middle Name:L
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-274-7492
Mailing Address - Street 1:PO BOX 57883
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84157-0883
Mailing Address - Country:US
Mailing Address - Phone:801-270-7492
Mailing Address - Fax:
Practice Address - Street 1:3333 S 900 E
Practice Address - Street 2:STE.# 103
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84106-2087
Practice Address - Country:US
Practice Address - Phone:801-270-7492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT=========001Medicaid