Provider Demographics
NPI:1538396668
Name:JKDB ENTERPRISES LLC
Entity type:Organization
Organization Name:JKDB ENTERPRISES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ONWER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:DOVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-224-0641
Mailing Address - Street 1:509 FM 369 N
Mailing Address - Street 2:
Mailing Address - City:IOWA PARK
Mailing Address - State:TX
Mailing Address - Zip Code:76367-7041
Mailing Address - Country:US
Mailing Address - Phone:940-224-0641
Mailing Address - Fax:940-855-5666
Practice Address - Street 1:509 FM 369 N
Practice Address - Street 2:
Practice Address - City:IOWA PARK
Practice Address - State:TX
Practice Address - Zip Code:76367-7041
Practice Address - Country:US
Practice Address - Phone:940-224-0641
Practice Address - Fax:940-855-5666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-16
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health