Provider Demographics
NPI:1841995487
Name:JECA HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:JECA HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:
Authorized Official - Last Name:NIYORUKUNDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-450-0011
Mailing Address - Street 1:7058 W PEBBLE VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85757-8745
Mailing Address - Country:US
Mailing Address - Phone:520-450-0011
Mailing Address - Fax:
Practice Address - Street 1:7058 W PEBBLE VALLEY DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85757-8745
Practice Address - Country:US
Practice Address - Phone:520-450-0011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care