Provider Demographics
NPI:1679788566
Name:J-J QUAL CARE HOME
Entity type:Organization
Organization Name:J-J QUAL CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSEE
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TIMBOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-478-1936
Mailing Address - Street 1:2251 HILL DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-1130
Mailing Address - Country:US
Mailing Address - Phone:323-478-1936
Mailing Address - Fax:323-478-7044
Practice Address - Street 1:1306 S HUDSON AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90019-3013
Practice Address - Country:US
Practice Address - Phone:323-939-3964
Practice Address - Fax:323-939-3964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities