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General NPI Number Information
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NPI Number | 1013540731
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Entity Type | Organization
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Legal Business Name | JFHS LLC
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Dates
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Enumeration Date | 02/20/2020
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Last Update Date | 05/22/2023
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Provider Practice Location Address
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Address Line | 18522 US HIGHWAY 18 STE 207
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City | APPLE VALLEY
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State | CA
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Zip | 92307-2321
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Country | US
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Telephone | 442-327-9172
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Fax |
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Provider Business Mailing Address
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Address Line | 15490 CIVIC DR STE 103
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City | VICTORVILLE
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State | CA
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Zip | 92392-2382
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Country | US
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Telephone | 442-327-9172
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Fax | 442-327-9173
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Authorized Official
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Title or Position | CEO
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Name | HARRY L JACKSON
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Credential |
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Telephone | 442-327-9172
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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