1063568764 NPI number — JHC OPERATIONS, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063568764 NPI number — JHC OPERATIONS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JHC OPERATIONS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063568764
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/30/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3010 LYNDON B JOHNSON FWY STE 1100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75234-2712
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
517-768-4373
Provider Business Mailing Address Fax Number:
903-537-8420

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
412 HIGHWAY 37 SOUTH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNT VERNON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75457-6570
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-537-3600
Provider Business Practice Location Address Fax Number:
903-537-3300
Provider Enumeration Date:
01/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MONASTIERE
Authorized Official First Name:
KATIE
Authorized Official Middle Name:
Authorized Official Title or Position:
COMPLIANCE PRIVACY&SAFETY OFFICER
Authorized Official Telephone Number:
517-768-4373

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  008275 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3747P1801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 245195161 . This is a "ANSI EDI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 245292163 . This is a "TDHCONNECT - CBA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 000696800 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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