Healthcare Provider Details

I. General information

NPI: 1407298185
Provider Name (Legal Business Name): VM JONES CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2013
Last Update Date: 07/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4280 BANYAN TRAILS DR
COCONUT CREEK FL
33073-5104
US

IV. Provider business mailing address

4280 BANYAN TRAILS DR
COCONUT CREEK FL
33073-5104
US

V. Phone/Fax

Practice location:
  • Phone: 954-854-9325
  • Fax: 954-427-9012
Mailing address:
  • Phone: 954-854-9325
  • Fax: 954-427-9012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. VINCENT MAURICE JONES
Title or Position: MANAGER
Credential:
Phone: 954-854-9325