Provider Demographics
NPI:1922540848
Name:JUKECO ENTERPRISES LLC
Entity Type:Organization
Organization Name:JUKECO ENTERPRISES LLC
Other - Org Name:BRUNSWICK NURSING HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:REICHERT
Authorized Official - Suffix:
Authorized Official - Credentials:RN, LNHA
Authorized Official - Phone:660-414-8502
Mailing Address - Street 1:19640 IOWAS RD
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:MO
Mailing Address - Zip Code:65236-2317
Mailing Address - Country:US
Mailing Address - Phone:660-414-8502
Mailing Address - Fax:
Practice Address - Street 1:721 W HARRISON ST
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:MO
Practice Address - Zip Code:65236-1096
Practice Address - Country:US
Practice Address - Phone:660-548-3182
Practice Address - Fax:660-548-3813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-09
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOLC001511052314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility