Provider Demographics
NPI:1740554633
Name:JADAZCH HOME HEALTH SERVICES
Entity type:Organization
Organization Name:JADAZCH HOME HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:NKEM
Authorized Official - Last Name:CHIOMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-455-5521
Mailing Address - Street 1:902 GRAFTON GARDEN LN
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:TX
Mailing Address - Zip Code:77545-7172
Mailing Address - Country:US
Mailing Address - Phone:281-455-5521
Mailing Address - Fax:
Practice Address - Street 1:902 GRAFTON GARDEN LN
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:TX
Practice Address - Zip Code:77545-7172
Practice Address - Country:US
Practice Address - Phone:281-455-5521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JADAZCH BALM CARE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-02-24
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251J00000XAgenciesNursing Care
No251S00000XAgenciesCommunity/Behavioral Health
No251V00000XAgenciesVoluntary or Charitable