Provider Demographics
NPI:1437953734
Name:JJACKS LLC
Entity type:Organization
Organization Name:JJACKS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:K
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-524-3877
Mailing Address - Street 1:500 FENCEPOST LN
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-8142
Mailing Address - Country:US
Mailing Address - Phone:803-853-3088
Mailing Address - Fax:
Practice Address - Street 1:2241 EBENEZER RD STE 12
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-9288
Practice Address - Country:US
Practice Address - Phone:803-853-3088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOME LIFE HOME CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care