Provider Demographics
NPI:1871638288
Name:JERICHO HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:JERICHO HEALTH SERVICES, INC.
Other - Org Name:JERICHO HEALTH SERVICES, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.F.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:ZAUL
Authorized Official - Middle Name:Z
Authorized Official - Last Name:ZAMORA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-546-7500
Mailing Address - Street 1:954 E MADISON ST
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-5950
Mailing Address - Country:US
Mailing Address - Phone:956-546-7500
Mailing Address - Fax:956-546-3245
Practice Address - Street 1:954 E MADISON ST
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-5950
Practice Address - Country:US
Practice Address - Phone:956-546-7500
Practice Address - Fax:956-546-3245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009279251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001013850OtherCBA CONTRACT
TX001013849OtherPHC CONTRACT
TX009279OtherLICENSE