Provider Demographics
NPI:1821730268
Name:JLK HOME CARE INC
Entity Type:Organization
Organization Name:JLK HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
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 1:3210 W CHARLESTON BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-0080
Mailing Address - Country:US
Mailing Address - Phone:702-234-8191
Mailing Address - Fax:702-369-3334
Practice Address - Street 1:3210 W CHARLESTON BLVD STE 2NA
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2030
Practice Address - Country:US
Practice Address - Phone:170-289-3200
Practice Address - Fax:702-369-3334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health