Provider Demographics
NPI: | 1871060194 |
---|---|
Name: | JAM HEALTHCARE SERVICES, LLC |
Entity type: | Organization |
Organization Name: | JAM HEALTHCARE SERVICES, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER/C.E.O. |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JUANITA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MARTIN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 407-203-8863 |
Mailing Address - Street 1: | 750 S ORANGE BLOSSOM TRL STE 41 |
Mailing Address - Street 2: | |
Mailing Address - City: | ORLANDO |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 32805-3138 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 407-203-8863 |
Mailing Address - Fax: | 407-572-8941 |
Practice Address - Street 1: | 750 S ORANGE BLOSSOM TRL STE 41 |
Practice Address - Street 2: | |
Practice Address - City: | ORLANDO |
Practice Address - State: | FL |
Practice Address - Zip Code: | 32805-3138 |
Practice Address - Country: | US |
Practice Address - Phone: | 407-203-8863 |
Practice Address - Fax: | 407-572-8941 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2018-10-24 |
Last Update Date: | 2019-01-31 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 251E00000X | Agencies | Home Health | Group - Multi-Specialty | |
No | 106S00000X | Behavioral Health & Social Service Providers | Behavior Technician | Group - Multi-Specialty | |
No | 246RP1900X | Technologists, Technicians & Other Technical Service Providers | Technician, Pathology | Phlebotomy | Group - Multi-Specialty |
No | 247ZC0005X | Technologists, Technicians & Other Technical Service Providers | Technician, Pathology | Clinical Laboratory Director, Non-physician | Group - Multi-Specialty |
No | 251C00000X | Agencies | Day Training, Developmentally Disabled Services | ||
No | 261QD1600X | Ambulatory Health Care Facilities | Clinic/Center | Developmental Disabilities | Group - Multi-Specialty |
No | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) | Group - Multi-Specialty | |
No | 347C00000X | Transportation Services | Private Vehicle | Group - Multi-Specialty | |
No | 372500000X | Nursing Service Related Providers | Chore Provider | Group - Multi-Specialty | |
No | 372600000X | Nursing Service Related Providers | Adult Companion | Group - Multi-Specialty | |
No | 3747A0650X | Nursing Service Related Providers | Technician | Attendant Care Provider | Group - Multi-Specialty |
No | 3747P1801X | Nursing Service Related Providers | Technician | Personal Care Attendant | Group - Multi-Specialty |
No | 374U00000X | Nursing Service Related Providers | Home Health Aide | Group - Multi-Specialty | |
No | 376K00000X | Nursing Service Related Providers | Nurse's Aide | Group - Multi-Specialty | |
No | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program | Group - Multi-Specialty |