Provider Demographics
NPI:1700502465
Name:AJ&B HOME CARE AGENCY LLC
Entity Type:Organization
Organization Name:AJ&B HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENALENE
Authorized Official - Middle Name:
Authorized Official - Last Name:ULLEGUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-634-6040
Mailing Address - Street 1:16724 YUKON AVE APT 6
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-1318
Mailing Address - Country:US
Mailing Address - Phone:310-634-6040
Mailing Address - Fax:
Practice Address - Street 1:2720 SEPULVEDA BLVD STE 300
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-2952
Practice Address - Country:US
Practice Address - Phone:310-634-6040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-14
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care