Organization
JAC SECOND, LLC
Active
Other names
Home Instead Senior Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACK ST.CLAIR (PRESIDENT)
(703) 464-1268
Entity
Organization
Contact information
Practice address
208 ELDEN ST STE 200, HERNDON, VA 20170-4836
(703) 464-1268
Mailing address
208 ELDEN ST STE 200, HERNDON, VA 20170-4836
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
HCO-151123
VA
Other
Enumeration date
02/12/2015
Last updated
02/12/2015
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