# JAC SECOND, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Home Instead Senior Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710378732
- **Authorized official:** MR. JACK ST.CLAIR (PRESIDENT)
- **Authorized official phone:** (703) 464-1268

## Contact information

- **Practice address:** 208 ELDEN ST STE 200, HERNDON, VA 20170-4836
- **Practice address phone:** (703) 464-1268
- **Mailing address:** 208 ELDEN ST STE 200, HERNDON, VA 20170-4836

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | HCO-151123 | VA | Yes |

## Other

- **Enumeration date:** 02/12/2015
- **Last updated:** 02/12/2015