Provider Demographics
NPI:1891041471
Name:JALAZAR INDUSTRIES LLC
Entity Type:Organization
Organization Name:JALAZAR INDUSTRIES LLC
Other - Org Name:BLUE POINTE HOME CARE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-454-1703
Mailing Address - Street 1:PO BOX 36832
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-0832
Mailing Address - Country:US
Mailing Address - Phone:313-454-1703
Mailing Address - Fax:313-499-8259
Practice Address - Street 1:1010 ANTIETAM AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48207-2832
Practice Address - Country:US
Practice Address - Phone:313-454-1703
Practice Address - Fax:313-499-8259
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JALAZAR INDUSTRIES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-01
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health