Jbg Holding Company LLC
NPI #1568459279 in Port Jefferson Station, New York
Provider Information
- NPI Number
- 1568459279
- Entity Type
- Organization
- Organization Name
- Jbg Holding Company LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Sep 29, 2005
- Last Updated
- Feb 24, 2012
Practice Location
- Address
- 1360 ROUTE 112
- State
- New York
- ZIP Code
- 11776-3078
- Phone
- (631) 473-7100
Authorized Official
- Name
- MR. KENNETH GAUL
- Title
- ADMINISTRATOR
- Phone
- (631) 473-7100
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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