Provider Demographics
NPI:1679386528
Name:JAYBIRD HOLDINGS INDIANOLA LLC
Entity type:Organization
Organization Name:JAYBIRD HOLDINGS INDIANOLA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMMUNITY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:PRIOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-961-1924
Mailing Address - Street 1:604 E HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:INDIANOLA
Mailing Address - State:IA
Mailing Address - Zip Code:50125-9032
Mailing Address - Country:US
Mailing Address - Phone:515-961-1924
Mailing Address - Fax:515-961-1956
Practice Address - Street 1:604 E HILLCREST DR
Practice Address - Street 2:
Practice Address - City:INDIANOLA
Practice Address - State:IA
Practice Address - Zip Code:50125-9032
Practice Address - Country:US
Practice Address - Phone:515-961-1924
Practice Address - Fax:515-961-1956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility