Jac Second, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

HCO-151123 Issued in VA

Legal business name

JAC SECOND, LLC

Doing business as

Home Instead Senior Care

Practice address

208 Elden St Ste 200
Herndon, VA 20170-4836

Phone

(703) 464-1268

NPI assigned

Feb 12, 2015

Last updated

Feb 12, 2015By 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. Jack St.Clair

Title

President

Phone

(703) 464-1268

Specialties & licenses 1

Addresses

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": "1423699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423699200000",
    "number": "1710378732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 ELDEN ST STE 200",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 ELDEN ST STE 200",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704836",
            "telephone_number": "703-464-1268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAC SECOND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-12",
        "last_updated": "2015-02-12",
        "status": "A",
        "authorized_official_last_name": "ST.CLAIR",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-464-1268",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "VA",
            "license": "HCO-151123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Home Instead Senior Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• It Is Well LLC
• Sabita M. Ittoop, MD
• Ravi R Iyer, M.D.
• J Chong DMD & Associates PC (Herndon Dental Design)
• J. Brian Queen, DDS, PC
• Lauren Jackey, RDN
• Theresa Jacob, LPC
• Jacobra LLC (Lice Clinics of America - NOVA)
• Gayathri Jagadeesan
• Tanin Jahan

• In Home Supportive Care Agency in Herndon, VA
• Providers in Herndon, VA by specialty
• In Home Supportive Care Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2015; 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.