Provider Demographics
NPI:1750015137
Name:J & S HOMECARE PROVIDERS, LLC
Entity type:Organization
Organization Name:J & S HOMECARE PROVIDERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SEONG
Authorized Official - Middle Name:HO
Authorized Official - Last Name:AN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-880-7738
Mailing Address - Street 1:5633 BRENDLYNN DR
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-7660
Mailing Address - Country:US
Mailing Address - Phone:770-880-7738
Mailing Address - Fax:
Practice Address - Street 1:5633 BRENDLYNN DR
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-7660
Practice Address - Country:US
Practice Address - Phone:770-880-7738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-12
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care