1477803955 NPI number — JUBILEE HOME CARE SERVICES OF HOUSTON INC

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 1477803955 NPI number — JUBILEE HOME CARE SERVICES OF HOUSTON INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JUBILEE HOME CARE SERVICES OF HOUSTON INC
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:
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:
1477803955
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/10/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
401 WHITNEY AVE
Provider Second Line Business Mailing Address:
STE 210
Provider Business Mailing Address City Name:
GRETNA
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70056-2558
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-368-5336
Provider Business Mailing Address Fax Number:
504-368-5339

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9950 WESTPARK DR
Provider Second Line Business Practice Location Address:
STE 638
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77063-5138
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-368-5336
Provider Business Practice Location Address Fax Number:
504-368-5339
Provider Enumeration Date:
09/12/2012

Additional Information

Authorized Official

Authorized Official Last Name:
CRAFT
Authorized Official First Name:
VASHON
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
504-368-5336

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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