Provider Demographics
NPI:1457756736
Name:JASMINE CARE, LLC
Entity Type:Organization
Organization Name:JASMINE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:OWEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-782-4657
Mailing Address - Street 1:2370 LARK ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-4320
Mailing Address - Country:US
Mailing Address - Phone:225-332-5600
Mailing Address - Fax:225-332-5677
Practice Address - Street 1:9151 INTERLINE AVE
Practice Address - Street 2:SUITE 6B
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-1970
Practice Address - Country:US
Practice Address - Phone:225-332-5600
Practice Address - Fax:225-332-5677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-28
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1375306251C00000X
LA1375128251C00000X
LA1375021251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1375128Medicaid
LA1375021Medicaid
LA1375306Medicaid