Provider Demographics
NPI:1255937660
Name:BUNDLES OF JOY PNCC SERVICES LLC
Entity type:Organization
Organization Name:BUNDLES OF JOY PNCC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-704-5201
Mailing Address - Street 1:8029 N SHERMAN BLVD
Mailing Address - Street 2:
Mailing Address - City:BROWN DEER
Mailing Address - State:WI
Mailing Address - Zip Code:53209-1515
Mailing Address - Country:US
Mailing Address - Phone:414-704-5201
Mailing Address - Fax:
Practice Address - Street 1:8029 N SHERMAN BLVD
Practice Address - Street 2:
Practice Address - City:BROWN DEER
Practice Address - State:WI
Practice Address - Zip Code:53209-1515
Practice Address - Country:US
Practice Address - Phone:414-704-5201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health