Provider Demographics
NPI:1255989364
Name:JUBILEE HOME HEALTH CARE INC
Entity type:Organization
Organization Name:JUBILEE HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AUGUSTINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:TUDEME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-485-6925
Mailing Address - Street 1:2002 CONGRESSIONAL DR UNIT 460291
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-5146
Mailing Address - Country:US
Mailing Address - Phone:615-485-6925
Mailing Address - Fax:314-338-4911
Practice Address - Street 1:3245 DOMAIN ST
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-8252
Practice Address - Country:US
Practice Address - Phone:615-485-6925
Practice Address - Fax:314-338-4911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-01
Last Update Date:2019-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health