Provider Demographics
NPI:1912284969
Name:TJRJ SPECIAL SUPPORT INC.
Entity Type:Organization
Organization Name:TJRJ SPECIAL SUPPORT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:LAFOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-663-1480
Mailing Address - Street 1:17808 NW 59TH AVE
Mailing Address - Street 2:UNIT #102
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-5157
Mailing Address - Country:US
Mailing Address - Phone:786-663-1480
Mailing Address - Fax:
Practice Address - Street 1:17808 NW 59TH AVE
Practice Address - Street 2:UNIT #102
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-5157
Practice Address - Country:US
Practice Address - Phone:786-663-1480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health