Jak Properties Inc

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

JAK PROPERTIES INC

Practice address

400 M C Black Rd
Bonne Terre, MO 63628-3649

Phone

(573) 358-7755

Fax

(573) 358-7788

NPI assigned

Apr 12, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Amy Sue Proffer

Title

President/Ceo

Phone

(573) 358-7755

Specialties & licenses 4

Addresses

Other names 2

• A1 Home Care Doing business as
• A1 Adult Day Habilitation Center Other name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671753600000",
    "number": "1295092500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 M C BLACK RD",
            "city": "BONNE TERRE",
            "state": "MO",
            "postal_code": "636283649",
            "telephone_number": "573-358-7755",
            "fax_number": "573-358-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 M C BLACK RD",
            "city": "BONNE TERRE",
            "state": "MO",
            "postal_code": "636283649",
            "telephone_number": "573-358-7755",
            "fax_number": "573-358-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAK PROPERTIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-12",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-23",
        "status": "A",
        "authorized_official_last_name": "PROFFER",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "573-358-7755"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chore Provider",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A1 Home Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "A1 Adult Day Habilitation Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Susan K Holman, R.PH.
• Bali Rae Hoover-Richardson, LPC
• Mandy Howard
• Charles Allen Hubbard, PT
• Kathleen Keaton Hubbard, PTA
• Mary Suzanne Jones, FNP-BC
• Meggan Jones
• Andrea Kahn, MS CCC-SLP
• Kingdom United Education Incorporated
• Pamela Sue Kiser, M.A.,CCC-SLP

• Adult Day Care Clinic/Center in Bonne Terre, MO
• Providers in Bonne Terre, MO by specialty
• Adult Day Care Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.