Provider Demographics
NPI:1811393366
Name:JL HEALTHCARE, LLC
Entity Type:Organization
Organization Name:JL HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:M
Authorized Official - Last Name:GORDEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:414-217-2495
Mailing Address - Street 1:3062 N 58TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53210-1545
Mailing Address - Country:US
Mailing Address - Phone:414-217-2495
Mailing Address - Fax:414-445-3893
Practice Address - Street 1:3062 N 58TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53210-1545
Practice Address - Country:US
Practice Address - Phone:414-217-2495
Practice Address - Fax:414-445-3893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-11
Last Update Date:2014-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI109525251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management