Provider Demographics
NPI:1720838972
Name:JAHVESTA HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:JAHVESTA HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:WAH
Authorized Official - Last Name:WLEH
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:763-439-2267
Mailing Address - Street 1:8440 MORGAN AVE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55444-1474
Mailing Address - Country:US
Mailing Address - Phone:763-439-2267
Mailing Address - Fax:
Practice Address - Street 1:8440 MORGAN AVE N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55444-1474
Practice Address - Country:US
Practice Address - Phone:763-439-2267
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health