Healthcare Provider Details

I. General information

NPI: 1518173616
Provider Name (Legal Business Name): JT ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 05/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 MAYS BR
PRESTONSBURG KY
41653-7810
US

IV. Provider business mailing address

406 MAYS BR
PRESTONSBURG KY
41653-7810
US

V. Phone/Fax

Practice location:
  • Phone: 606-874-1900
  • Fax: 606-874-1902
Mailing address:
  • Phone: 606-889-9695
  • Fax: 606-889-9695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number StateKY

VIII. Authorized Official

Name: MS. MARY JOYCE BATES
Title or Position: PRESIDENT
Credential:
Phone: 606-889-9695