Provider Demographics
NPI:1942572268
Name:JADAZCH BALM CARE INC
Entity Type:Organization
Organization Name:JADAZCH BALM CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIOMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-455-5521
Mailing Address - Street 1:902 GRAFTON GARDEN LN
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:TX
Mailing Address - Zip Code:77545-7172
Mailing Address - Country:US
Mailing Address - Phone:281-455-5521
Mailing Address - Fax:
Practice Address - Street 1:902 GRAFTON GARDEN LN
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:TX
Practice Address - Zip Code:77545-7172
Practice Address - Country:US
Practice Address - Phone:281-455-5521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-01
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 320900000X
TX0000320600000X, 341600000X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No341600000XTransportation ServicesAmbulance
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000000OtherHCS
TX000000Medicaid
TX000000Medicare PIN