# JETTA BLUE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386409548
- **Authorized official:** LATONYA SASHINGTON (OWNER)
- **Authorized official phone:** (269) 601-6800

## Contact information

- **Practice address:** 3401 CAPITAL AVE SW APT 21A, BATTLE CREEK, MI 49015-8320
- **Practice address phone:** (269) 601-8800
- **Mailing address:** 3401 CAPITAL AVE SW APT 21A, BATTLE CREEK, MI 49015-8320
- **Mailing address phone:** (269) 601-6800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 02/16/2024
- **Last updated:** 02/16/2024