Provider Demographics
NPI:1982201935
Name:J & J ASSISTED LIVING LLC
Entity Type:Organization
Organization Name:J & J ASSISTED LIVING LLC
Other - Org Name:J & J RESIDENTIAL CARE FACILITY II
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RCAL ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:GREBING
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:573-450-8047
Mailing Address - Street 1:PO BOX 378
Mailing Address - Street 2:
Mailing Address - City:MARBLE HILL
Mailing Address - State:MO
Mailing Address - Zip Code:63764-0378
Mailing Address - Country:US
Mailing Address - Phone:573-238-4602
Mailing Address - Fax:573-238-3233
Practice Address - Street 1:104 WESBECHER LN
Practice Address - Street 2:
Practice Address - City:MARBLE HILL
Practice Address - State:MO
Practice Address - Zip Code:63764
Practice Address - Country:US
Practice Address - Phone:573-238-4602
Practice Address - Fax:573-238-3233
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:J & J ASSISTED LIVING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-02
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty