Provider Demographics
NPI:1649649526
Name:JASON ROBERT HOME CARE
Entity type:Organization
Organization Name:JASON ROBERT HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:JERARD
Authorized Official - Last Name:ROBERT
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:845-473-1407
Mailing Address - Street 1:64 LENT ST
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-2728
Mailing Address - Country:US
Mailing Address - Phone:845-473-1407
Mailing Address - Fax:
Practice Address - Street 1:64 LENT ST
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-2728
Practice Address - Country:US
Practice Address - Phone:845-473-1407
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-21
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY323224251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care