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JAG'S RESIDENTIAL SERVICES, LLC
NPI 1093850620
Custodial Care Facility - Adult Care Home in Zebulon, NC

Active since February 21, 2007
1005 LAUREL LEAF RD, ZEBULON, NC 27597(919) 426-3752(919) 404-1515 Get Directions Write a Review

NPPES record last updated: September 8, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Sep 8, 2021, Aug 22, 2020 (2 updates tracked since 2020).

About Jag's Residential Services, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JAG'S RESIDENTIAL SERVICES, LLC (NPI 1093850620), doing business as Jag's Developmental Disability Adult Care, Llc, is a healthcare organization registered as an adult care home in Zebulon, North Carolina and active in the NPI registry since February 2007. The organization lists Gwendolyn Goolsby Johns, Owner / Director, as its authorized official.

NPPES Registry Identity

NPI1093850620
Entity TypeOrganization
Primary Taxonomy311ZA0620X
Legal Business NameJAG'S RESIDENTIAL SERVICES, LLC
Location Address1005 LAUREL LEAF RDZebulon, NC 27597
Mailing Address1006 Laurel Leaf RdZebulon, NC 27597 · (919) 426-3752 · Fax (919) 404-1515
Phone(919) 426-3752
Fax(919) 404-1515
Organization SubpartNo
Authorized OfficialGwendolyn Goolsby JohnsOwner / Director · (919) 426-3752
Enumeration DateFebruary 21, 2007
Last NPPES UpdateSeptember 8, 20212 updates tracked since enumeration
NPPES CertifiedSeptember 8, 2021
✔ NPI 1093850620 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCustodial Care Facility · Adult Care HomeNursing & Custodial Care Facilities
Taxonomy Code311ZA0620X
Definition

A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.

Also ListedCustodial Care FacilityTaxonomy 311Z00000X
Also ListedCommunity Based Residential Treatment Facility, Mental IllnessTaxonomy 320800000X · License MHL-092-639 (NC)
1005 LAUREL LEAF RD, Zebulon, NC 27597
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Other Names 1

Former Legal Business NameJag's Developmental Disability Adult Care, Llc

Other Identifiers 1

Medicaid7805466NC

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jag's Residential Services, LLC's NPI number?

The NPI number for Jag's Residential Services, LLC is 1093850620. It was assigned to this organization in the NPPES registry on February 21, 2007. The provider was formerly known as Jag's Developmental Disability Adult Care, LLC.

Where is Jag's Residential Services, LLC located?

Jag's Residential Services, LLC is located at 1005 Laurel Leaf Rd, Zebulon, NC 27597. The listed phone number is (919) 426-3752.

What is Jag's Residential Services, LLC's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

When was this NPI record last updated?

The NPPES record for Jag's Residential Services, LLC was last updated on September 8, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.