Provider Demographics
NPI:1295002608
Name:JCS HOME HEALTH, INC.
Entity type:Organization
Organization Name:JCS HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:RUEHLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-541-4133
Mailing Address - Street 1:1505 SE 40TH ST.
Mailing Address - Street 2:STE. C
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904
Mailing Address - Country:US
Mailing Address - Phone:239-541-4133
Mailing Address - Fax:239-541-4135
Practice Address - Street 1:1505 SE 40TH ST.
Practice Address - Street 2:STE. C
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904
Practice Address - Country:US
Practice Address - Phone:239-541-4133
Practice Address - Fax:239-541-4135
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JCS HOME HEALTH, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-11-30
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299993396251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004324100Medicaid
FL299993396OtherFLORIDA HHA LICENSE