Jedconnect, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

194700052 Issued in CA

Legal business name

JEDCONNECT, LLC

Doing business as

Home Instead Senior Care

Practice address

5601 W Slauson Ave
Suite 255
Culver City, CA 90230-6582

Phone

(310) 645-8475

Fax

(310) 645-8415

NPI assigned

May 4, 2017

Last updated

May 4, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Eric David Carr

Title

Franchise Owner

Phone

31306458475

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Home Instead Senior Care Doing business as

Locations

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

{
    "created_epoch": "1493856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493856000000",
    "number": "1336675792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 W SLAUSON AVE",
            "address_2": "SUITE 255",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902306582",
            "telephone_number": "310-645-8475",
            "fax_number": "310-645-8415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 W SLAUSON AVE",
            "address_2": "SUITE 255",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902306582",
            "telephone_number": "310-645-8475",
            "fax_number": "310-645-8415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEDCONNECT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-04",
        "last_updated": "2017-05-04",
        "status": "A",
        "authorized_official_last_name": "CARR",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "FRANCHISE OWNER",
        "authorized_official_telephone_number": "31306458475",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "CA",
            "license": "194700052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOME CARE SERVICES BUREAU",
            "identifier": "194700052",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Home Instead Senior Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• In Home Supportive Care Agency in Culver City, CA
• Providers in Culver City, CA by specialty
• In Home Supportive Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2017; 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.