Provider Demographics
NPI:1902803752
Name:JOBET CORPORATION
Entity Type:Organization
Organization Name:JOBET CORPORATION
Other - Org Name:DEDICATED HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAURITZEN
Authorized Official - Suffix:
Authorized Official - Credentials:NHA 7607
Authorized Official - Phone:818-548-2684
Mailing Address - Street 1:1919 WILLIAMS ST STE 310
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-7842
Mailing Address - Country:US
Mailing Address - Phone:818-548-2684
Mailing Address - Fax:818-548-7384
Practice Address - Street 1:1919 WILLIAMS ST STE 310
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-7842
Practice Address - Country:US
Practice Address - Phone:818-548-2684
Practice Address - Fax:818-548-7384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980001394251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA058153Medicare ID - Type UnspecifiedHOME HEALTH AGENCY