Organization
JESUS IS LORD HEALTHCARE SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOROTHY JACKSON (CEO)
(706) 790-0767
Entity
Organization
Contact information
Practice address
2764 TOBACCO RD, HEPHZIBAH, GA 30815-7014
(706) 790-5836
(706) 790-0767
Mailing address
2764 TOBACCO RD, HEPHZIBAH, GA 30815-7014
(706) 790-5836
(706) 790-0767
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
021-R-0019
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000804889A
—
GA
05
—
000804889B
—
GA
05
—
000804889C
—
GA
05
—
000804889D
—
GA
05
—
000804889G
—
GA
05
—
000804889H
—
GA
05
—
000804889K
—
GA
Enumeration date
05/24/2007
Last updated
06/02/2020
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