Healthcare Provider Details

I. General information

NPI: 1285060111
Provider Name (Legal Business Name): JFM INSPIRATIONS COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2013
Last Update Date: 09/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2427 N 71ST AVE
PHOENIX AZ
85035-2611
US

IV. Provider business mailing address

2427 N 71ST AVE
PHOENIX AZ
85035-2611
US

V. Phone/Fax

Practice location:
  • Phone: 623-251-5953
  • Fax: 623-256-6992
Mailing address:
  • Phone: 623-251-5953
  • Fax: 623-256-6992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License NumberBH-4296
License Number StateAZ

VIII. Authorized Official

Name: SANOVA DEAR
Title or Position: PROGRAM COORDINATOR
Credential:
Phone: 480-343-0086