Provider Demographics
NPI:1932893237
Name:JORDAN HOME CARE INC
Entity Type:Organization
Organization Name:JORDAN HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NAQUITA
Authorized Official - Middle Name:
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:132-305-7517
Mailing Address - Street 1:2446 DIANNE DR
Mailing Address - Street 2:
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32926-5304
Mailing Address - Country:US
Mailing Address - Phone:321-305-7517
Mailing Address - Fax:321-208-8311
Practice Address - Street 1:2446 DIANNE DR
Practice Address - Street 2:
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32926-5304
Practice Address - Country:US
Practice Address - Phone:321-480-5371
Practice Address - Fax:321-208-8311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty