Provider Demographics
NPI:1336746395
Name:J & M COMPANION SERVICES LLC
Entity Type:Organization
Organization Name:J & M COMPANION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED NURSING ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:MAXENE
Authorized Official - Middle Name:CARLENE
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-374-7263
Mailing Address - Street 1:42 STUYVESANT ST
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11717-1523
Mailing Address - Country:US
Mailing Address - Phone:631-374-7463
Mailing Address - Fax:
Practice Address - Street 1:42 STUYVESANT ST
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-1523
Practice Address - Country:US
Practice Address - Phone:631-374-7463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-02
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty