Provider Demographics
NPI:1902399157
Name:D & J HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:D & J HEALTH SERVICES, LLC
Other - Org Name:D & J HEALTH SERVICES, LLC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BARRAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-235-4712
Mailing Address - Street 1:25 MORRO BAY DR
Mailing Address - Street 2:
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578-4280
Mailing Address - Country:US
Mailing Address - Phone:832-235-4712
Mailing Address - Fax:979-200-2106
Practice Address - Street 1:25 MORRO BAY DR
Practice Address - Street 2:
Practice Address - City:MANVEL
Practice Address - State:TX
Practice Address - Zip Code:77578-4280
Practice Address - Country:US
Practice Address - Phone:832-235-4712
Practice Address - Fax:979-200-2106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-12
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001030306Medicaid