Provider Demographics
NPI:1245964816
Name:JLK HOME CARE, INC
Entity type:Organization
Organization Name:JLK HOME CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATE
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-893-2001
Mailing Address - Street 1:3210 W CHARLESTON BLVD STE 2NA
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-2030
Mailing Address - Country:US
Mailing Address - Phone:702-234-8191
Mailing Address - Fax:702-369-3334
Practice Address - Street 1:3210 W CHARLESTON BLVD STE 2NA
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2030
Practice Address - Country:US
Practice Address - Phone:702-893-8001
Practice Address - Fax:702-369-3334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-11
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty