Healthcare Provider Details

I. General information

NPI: 1699679944
Provider Name (Legal Business Name): JDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 SW 29TH ST STE 108
TOPEKA KS
66614-2015
US

IV. Provider business mailing address

1911 SW COLLINS AVE
TOPEKA KS
66604-3222
US

V. Phone/Fax

Practice location:
  • Phone: 785-580-8904
  • Fax:
Mailing address:
  • Phone: 785-580-8904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. JENNIFER D ANDERSON
Title or Position: CLINICAL SOCIAL WORKER
Credential: LSCSW
Phone: 785-580-8904