Provider Demographics
NPI:1982691853
Name:JDC & ASSOCIATES, INC
Entity Type:Organization
Organization Name:JDC & ASSOCIATES, INC
Other - Org Name:WALDEN MEADOWS HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:JEFFEREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-262-7397
Mailing Address - Street 1:5278 PINEMONT DR
Mailing Address - Street 2:A-120
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84123-2711
Mailing Address - Country:US
Mailing Address - Phone:801-262-7397
Mailing Address - Fax:801-262-8011
Practice Address - Street 1:5278 PINEMONT DR
Practice Address - Street 2:A-120
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84123-2711
Practice Address - Country:US
Practice Address - Phone:801-262-7397
Practice Address - Fax:801-262-8011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0593350Medicaid
UT=========005Medicaid
IA0593350Medicaid