# JAY E DEVILLE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1407508948
- **Gender:** Man
- **Credential:** OWNER

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 057-R-0017 | GA | — |
| 253Z00000X | In Home Supportive Care Agency | 057-R00-17 | GA | Yes |
| 253Z00000X | In Home Supportive Care Agency | 057R0017 | GA | — |
| 374U00000X | Home Health Aide | 057-R-0017 | GA | — |

## Other

- **Enumeration date:** 01/26/2022
- **Last updated:** 05/31/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1770031478 | — | GA |