Provider Demographics
NPI:1013130244
Name:MJSR ENTERPRISES LLC
Entity Type:Organization
Organization Name:MJSR ENTERPRISES LLC
Other - Org Name:COMFORT KEEPERS OF LA CROSSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:S
Authorized Official - Last Name:STOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-784-3356
Mailing Address - Street 1:2101 VICTORY ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601-7380
Mailing Address - Country:US
Mailing Address - Phone:608-784-3356
Mailing Address - Fax:608-784-3397
Practice Address - Street 1:2101 VICTORY ST
Practice Address - Street 2:SUITE B
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-7380
Practice Address - Country:US
Practice Address - Phone:608-784-3356
Practice Address - Fax:608-784-3397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health