Provider Demographics
NPI:1871686931
Name:JLG HEALTH GROUP, LLC
Entity type:Organization
Organization Name:JLG HEALTH GROUP, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:GRACIELA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:956-857-5900
Mailing Address - Street 1:1605 E DEL MAR BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6518
Mailing Address - Country:US
Mailing Address - Phone:956-857-5900
Mailing Address - Fax:956-718-2354
Practice Address - Street 1:1605 E DEL MAR BLVD STE 103
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6518
Practice Address - Country:US
Practice Address - Phone:956-857-5900
Practice Address - Fax:956-718-2354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679506Medicare ID - Type UnspecifiedPROVIDER NUMBER
679506Medicare Oscar/Certification