Provider Demographics
NPI:1255641445
Name:J K AND M ENTERPRISE, LLC
Entity type:Organization
Organization Name:J K AND M ENTERPRISE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:LYNETTE
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:936-637-1162
Mailing Address - Street 1:604 MORROW ST
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-4626
Mailing Address - Country:US
Mailing Address - Phone:936-637-1162
Mailing Address - Fax:936-637-1162
Practice Address - Street 1:604 MORROW ST
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-4626
Practice Address - Country:US
Practice Address - Phone:936-637-1162
Practice Address - Fax:936-637-1162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-21
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health