Provider Demographics
NPI:1770975500
Name:JG HOME HEALTH CARE SERVICES LLC
Entity type:Organization
Organization Name:JG HOME HEALTH CARE SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CEO/ ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JYOTSNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAKULLAVARAPU
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH, CDP
Authorized Official - Phone:781-667-3220
Mailing Address - Street 1:394 LOWELL ST STE 11
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-2550
Mailing Address - Country:US
Mailing Address - Phone:781-667-3220
Mailing Address - Fax:781-667-3221
Practice Address - Street 1:394 LOWELL ST STE 11
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-2550
Practice Address - Country:US
Practice Address - Phone:781-667-3220
Practice Address - Fax:781-667-3221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-03
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health