Provider Demographics
NPI:1952611527
Name:JRL PATIENT HEALTH CARE SERVICES
Entity type:Organization
Organization Name:JRL PATIENT HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:REDOR
Authorized Official - Last Name:LIM
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:323-805-1113
Mailing Address - Street 1:1680 TARTAR LANE
Mailing Address - Street 2:22
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90221
Mailing Address - Country:US
Mailing Address - Phone:323-805-1113
Mailing Address - Fax:310-884-9375
Practice Address - Street 1:1680 TARTAR LANE
Practice Address - Street 2:22
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90221
Practice Address - Country:US
Practice Address - Phone:323-805-1113
Practice Address - Fax:310-884-9375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00693142253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care