Provider Demographics
| NPI: | 1801490149 |
|---|---|
| Name: | J & L INNOVATIONS, LLC |
| Entity type: | Organization |
| Organization Name: | J & L INNOVATIONS, LLC |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CEO/OWNER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | JASCHICA |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | SHELLEY |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | MSN, APRN, FNP |
| Authorized Official - Phone: | 469-890-4718 |
| Mailing Address - Street 1: | 791 N. HIGHWAY 77 |
| Mailing Address - Street 2: | SUITE 501C- BOX 228 |
| Mailing Address - City: | WAXAHACHIE |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 75165-2573 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 469-570-6511 |
| Mailing Address - Fax: | 469-570-6509 |
| Practice Address - Street 1: | 2801 N HIGHWAY 77 STE 210 |
| Practice Address - Street 2: | |
| Practice Address - City: | WAXAHACHIE |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 75165-6110 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 469-570-6511 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | Yes |
| Parent Organization LBN: | J & L INNOVATIONS, LLC |
| Parent Organization TIN: | <UNAVAIL> |
| Enumeration Date: | 2020-11-27 |
| Last Update Date: | 2024-07-08 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 3747P1801X | Nursing Service Related Providers | Technician | Personal Care Attendant | Group - Multi-Specialty |
| No | 174200000X | Other Service Providers | Meals | ||
| No | 177F00000X | Other Service Providers | Lodging | Group - Multi-Specialty | |
| No | 251C00000X | Agencies | Day Training, Developmentally Disabled Services | ||
| No | 251T00000X | Agencies | Program of All-Inclusive Care for the Elderly (PACE) Provider Organization | ||
| No | 253Z00000X | Agencies | In Home Supportive Care | ||
| No | 261QA0600X | Ambulatory Health Care Facilities | Clinic/Center | Adult Day Care | |
| No | 310400000X | Nursing & Custodial Care Facilities | Assisted Living Facility | ||
| No | 310500000X | Nursing & Custodial Care Facilities | Intermediate Care Facility, Mental Illness | ||
| No | 311500000X | Nursing & Custodial Care Facilities | Alzheimer Center (Dementia Center) | ||
| No | 311ZA0620X | Nursing & Custodial Care Facilities | Custodial Care Facility | Adult Care Home | |
| No | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | ||
| No | 320900000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | ||
| No | 343800000X | Transportation Services | Secured Medical Transport (VAN) | Group - Multi-Specialty | |
| No | 385HR2050X | Respite Care Facility | Respite Care | Respite Care Camp | Group - Multi-Specialty |
