Provider Demographics
NPI:1700544210
Name:JALAMAR COMPASSIONATE CAREGIVERS LLC
Entity Type:Organization
Organization Name:JALAMAR COMPASSIONATE CAREGIVERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:SHELTON VANCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-209-6826
Mailing Address - Street 1:5339 W MALDONADO RD
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-6968
Mailing Address - Country:US
Mailing Address - Phone:608-209-6826
Mailing Address - Fax:
Practice Address - Street 1:5339 W MALDONADO RD
Practice Address - Street 2:
Practice Address - City:LAVEEN
Practice Address - State:AZ
Practice Address - Zip Code:85339-6968
Practice Address - Country:US
Practice Address - Phone:608-209-6826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-01
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care