Provider Demographics
NPI:1811660426
Name:K&JAY COMMUNITY HOME LLC
Entity type:Organization
Organization Name:K&JAY COMMUNITY HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHEINE
Authorized Official - Middle Name:R
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-203-3157
Mailing Address - Street 1:701 LAREDO ST
Mailing Address - Street 2:
Mailing Address - City:NAVASOTA
Mailing Address - State:TX
Mailing Address - Zip Code:77868-2019
Mailing Address - Country:US
Mailing Address - Phone:832-203-3157
Mailing Address - Fax:
Practice Address - Street 1:701 LAREDO ST
Practice Address - Street 2:
Practice Address - City:NAVASOTA
Practice Address - State:TX
Practice Address - Zip Code:77868-2019
Practice Address - Country:US
Practice Address - Phone:832-203-3157
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-29
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care