Provider Demographics
NPI:1720818867
Name:JAAG HOME CARE, LLC
Entity type:Organization
Organization Name:JAAG HOME CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESSUMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-668-8177
Mailing Address - Street 1:725 HIGHWAY 287 N STE 511
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-3874
Mailing Address - Country:US
Mailing Address - Phone:817-973-5482
Mailing Address - Fax:817-973-5542
Practice Address - Street 1:725 HIGHWAY 287 N STE 511
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-3874
Practice Address - Country:US
Practice Address - Phone:404-668-8177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-05
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty