Provider Demographics
NPI:1649488958
Name:JAMDEN GROUP LLC
Entity type:Organization
Organization Name:JAMDEN GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-960-9999
Mailing Address - Street 1:12700 HILLCREST RD STE 276
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2061
Mailing Address - Country:US
Mailing Address - Phone:972-960-9999
Mailing Address - Fax:972-421-1503
Practice Address - Street 1:12700 HILLCREST RD STE 276
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2061
Practice Address - Country:US
Practice Address - Phone:972-960-9999
Practice Address - Fax:972-421-1503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010382251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX01010382OtherTEXAS LICENSE