Provider Demographics
NPI:1740894096
Name:JPN HOLDINGS CORP
Entity type:Organization
Organization Name:JPN HOLDINGS CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-850-2500
Mailing Address - Street 1:8275 S EASTERN AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-2545
Mailing Address - Country:US
Mailing Address - Phone:702-850-2500
Mailing Address - Fax:702-846-2511
Practice Address - Street 1:8275 S EASTERN AVE STE 246
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123
Practice Address - Country:US
Practice Address - Phone:702-850-2500
Practice Address - Fax:702-846-2511
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JPN HOLDINGS CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-09-03
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV9990-PCS-0OtherHOME CARE