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1073266557
JAY KYLE BLACK
LANCASTER, CA
NPI
1073266557
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Additional Taxonomies
171M00000X Case Manager/Care Coordinator
Enumeration Date
2022-02-03
Last Update Date
2023-05-22
Business Address
Mr. JAY KYLE BLACK
506 W JACKMAN ST
LANCASTER, CA 93534-2531
Phone number: 661-852-9466
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Mailing Address
Mr. JAY KYLE BLACK
506 W JACKMAN ST
LANCASTER, CA 93534-2531
Phone number:
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