Provider Demographics
NPI:1831433564
Name:JJL HEALTHCARE SERVICES
Entity type:Organization
Organization Name:JJL HEALTHCARE SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:LUHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-608-3838
Mailing Address - Street 1:2010 W. EAU GALLIE BLVD.
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-3114
Mailing Address - Country:US
Mailing Address - Phone:321-608-3838
Mailing Address - Fax:321-286-5808
Practice Address - Street 1:2010 W. EAU GALLIE BLVD.
Practice Address - Street 2:SUITE 101
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-3114
Practice Address - Country:US
Practice Address - Phone:321-608-3838
Practice Address - Fax:321-286-5808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-19
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008515200Medicaid