Provider Demographics
NPI:1851999544
Name:JS HOME & COMPANION CARE INC
Entity Type:Organization
Organization Name:JS HOME & COMPANION CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JAMIEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHACKELFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-348-8554
Mailing Address - Street 1:1361 TERRACE RD
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33755-2059
Mailing Address - Country:US
Mailing Address - Phone:727-348-8554
Mailing Address - Fax:
Practice Address - Street 1:1361 TERRACE RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33755-2059
Practice Address - Country:US
Practice Address - Phone:727-348-8554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL236498OtherAHCA