Provider Demographics
NPI:1104701770
Name:JMM DANCE CO
Entity type:Organization
Organization Name:JMM DANCE CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-771-1364
Mailing Address - Street 1:1311 AZALEA DR
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-6550
Mailing Address - Country:US
Mailing Address - Phone:408-771-1364
Mailing Address - Fax:
Practice Address - Street 1:440 SAN BENITO ST
Practice Address - Street 2:
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-3953
Practice Address - Country:US
Practice Address - Phone:408-600-5107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No251S00000XAgenciesCommunity/Behavioral Health