Provider Demographics
NPI:1144911470
Name:JP ENTERPRISE GROUP INC
Entity type:Organization
Organization Name:JP ENTERPRISE GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:RICHELLE
Authorized Official - Middle Name:OLETA
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-552-2266
Mailing Address - Street 1:1517 TENNESSEE ST
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-4654
Mailing Address - Country:US
Mailing Address - Phone:707-552-2266
Mailing Address - Fax:707-552-2773
Practice Address - Street 1:1517 TENNESSEE ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-4654
Practice Address - Country:US
Practice Address - Phone:707-552-2266
Practice Address - Fax:707-552-2773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty