Healthcare Provider Details

I. General information

NPI: 1164024113
Provider Name (Legal Business Name): JV THERAPY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2020
Last Update Date: 11/13/2020
Certification Date: 11/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8332 BROOKHAVEN DR
FRANKFORT IL
60423-8580
US

IV. Provider business mailing address

8332 BROOKHAVEN DR
FRANKFORT IL
60423-8580
US

V. Phone/Fax

Practice location:
  • Phone: 815-557-2728
  • Fax:
Mailing address:
  • Phone: 815-557-2728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: JASMINE RANDLE-MAYES
Title or Position: OCCUPATIONAL THERAPIST
Credential:
Phone: 815-557-2728