Provider Demographics
NPI:1437696630
Name:JE & JI, INC
Entity type:Organization
Organization Name:JE & JI, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JELEH
Authorized Official - Middle Name:
Authorized Official - Last Name:GBODI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-250-8693
Mailing Address - Street 1:312 SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-2909
Mailing Address - Country:US
Mailing Address - Phone:267-250-8693
Mailing Address - Fax:484-466-4906
Practice Address - Street 1:312 SHADELAND AVE
Practice Address - Street 2:
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-2909
Practice Address - Country:US
Practice Address - Phone:267-250-8693
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-25
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes305S00000XManaged Care OrganizationsPoint of Service
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1034616030001OtherWAIVER/DLTL
PA32863601Medicaid