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NPI Code Detail

MEDICARE: JPLUS

MEDICARE: JPLUS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency
2261QM0850XAdult Mental Health Clinic/Center
3261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1265162549
Entity Type Code : Organization
Provider Name (Legal Business Name) : JPLUS
Provider Business Mailing Address
First Line : 3920 W CHARLESTON BLVD STE N
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-1651
Country : US
Telephone Number : 702-478-5541
Fax Number :
Provider Business Practice Location Address
First Line : 3920 W CHARLESTON BLVD STE N
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-1651
Country : US
Telephone Number : 702-822-0447
Fax Number :
Authorized Official
Title or Position : OWNER
Name : SOJI OBAGBEMI
Credential :
Telephone Number : 702-487-5541
Provider Enumeration Date : 06/10/2022
Last Update Date : 06/15/2022

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Directions to “JPLUS ” Practice Location

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