Healthcare Provider Details

I. General information

NPI: 1982333506
Provider Name (Legal Business Name): JTB CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2022
Last Update Date: 06/08/2022
Certification Date: 06/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 W CENTRAL AVE
MAYWOOD NJ
07607-1101
US

IV. Provider business mailing address

71 W CENTRAL AVE
MAYWOOD NJ
07607-1101
US

V. Phone/Fax

Practice location:
  • Phone: 201-647-9470
  • Fax:
Mailing address:
  • Phone: 201-647-9470
  • Fax:

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 Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MS. BRIANNE BAKER
Title or Position: OWNER/FOUNDER
Credential:
Phone: 201-647-9470