Provider Demographics
NPI:1871863993
Name:J R ROUNTREE ENTERPRISES, INC.
Entity Type:Organization
Organization Name:J R ROUNTREE ENTERPRISES, INC.
Other - Org Name:ROUNTREE CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:ROUNTREE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-783-8368
Mailing Address - Street 1:6225 RINCON WAY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-2038
Mailing Address - Country:US
Mailing Address - Phone:214-783-8368
Mailing Address - Fax:
Practice Address - Street 1:304 STONE MOUNTAIN DR
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:TX
Practice Address - Zip Code:75182-2640
Practice Address - Country:US
Practice Address - Phone:214-783-8368
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-05
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care