Healthcare Provider Details

I. General information

NPI: 1689993388
Provider Name (Legal Business Name): JONES SPECIALTY HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2010
Last Update Date: 05/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1537 WESTWOOD DR NW
WARREN OH
44485-1837
US

IV. Provider business mailing address

1537 WESTWOOD DR NW
WARREN OH
44485-1837
US

V. Phone/Fax

Practice location:
  • Phone: 330-307-9970
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberS.0700233
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberSP-2496
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberS.0001909
License Number StateOH

VIII. Authorized Official

Name: MR. WILLIAM ANDREW JONES JR.
Title or Position: LISCENSED SOCIAL WORKER (PRESIDENT)
Credential: LSW
Phone: 330-307-9970