Provider Demographics
NPI:1912067455
Name:C AND J QUALITY JOBS LLC
Entity Type:Organization
Organization Name:C AND J QUALITY JOBS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHAWNNA
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:POINDEXTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-872-3801
Mailing Address - Street 1:610 WEST MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:CORYDON
Mailing Address - State:IA
Mailing Address - Zip Code:50060
Mailing Address - Country:US
Mailing Address - Phone:641-872-3801
Mailing Address - Fax:641-872-3802
Practice Address - Street 1:610 WEST MAPLE ST
Practice Address - Street 2:
Practice Address - City:CORYDON
Practice Address - State:IA
Practice Address - Zip Code:50060
Practice Address - Country:US
Practice Address - Phone:641-872-3801
Practice Address - Fax:641-872-3802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAX000201554Medicaid