Jag'S Developmental Disability Adult Care, Llc

LBN: Jag'S Residential Services, Llc
Jag'S Developmental Disability Adult Care, Llc is an health care organization with primary practice located at 1005 Laurel Leaf Rd , Zebulon NC 27597. The organization recently has 3 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Custodial Care Facility, Nursing & Custodial Care Facilities / Adult Care Home, Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness. Nursing & Custodial Care Facilities / Adult Care Home is the primary health care specialty. Jag'S Residential Services, Llc can be contacted via phone (919) 426-3752, or through Johns, Gwendolyn Goolsby via phone (919) 426-3752.

Contact Information

Primary practice address
1005 Laurel Leaf Rd Zebulon NC 27597
Phone: (919) 426-3752
Fax: (919) 404-1515
Website:
Map and Directions
Authorized official contact:
Name: Johns, Gwendolyn Goolsby
Phone: (919) 426-3752

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Custodial Care Facility 311Z00000X
Nursing & Custodial Care Facilities / Adult Care Home 311ZA0620X
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness 320800000X MHL-092-639 North Carolina

Profile Details

NPI number 1093850620
LBN Legal business name Jag'S Residential Services, Llc
DBA Doing business as Jag'S Developmental Disability Adult Care, Llc
Authorized official Johns, Gwendolyn Goolsby
Entity Organization
Organization subpart 1 No
Enumeration date Feb 21st, 2007
Last updated Sep 8th, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093850620 NPPES
North Carolina MEDICAID 7805466

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