Healthcare Provider Details

I. General information

NPI: 1013540731
Provider Name (Legal Business Name): JFHS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2020
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18522 US HIGHWAY 18 STE 207
APPLE VALLEY CA
92307-2321
US

IV. Provider business mailing address

18522 US HIGHWAY 18 STE 207-208
APPLE VALLEY CA
92307-2321
US

V. Phone/Fax

Practice location:
  • Phone: 442-327-9172
  • Fax:
Mailing address:
  • Phone: 442-327-9172
  • Fax: 442-327-9173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HARRY L JACKSON
Title or Position: CEO
Credential:
Phone: 442-327-9172