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General NPI Number Information
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NPI Number | 1043930530
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Entity Type | Organization
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Legal Business Name | THE JAYBIRD LEARNING ACADEMY, INC.
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Dates
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Enumeration Date | 09/02/2022
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 515 E VETERANS MEMORIAL BLVD STE B
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City | HARKER HEIGHTS
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State | TX
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Zip | 76548-1693
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Country | US
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Telephone | 561-209-3565
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Fax | 254-294-3207
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Provider Business Mailing Address
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Address Line | 6403 MUSTANG CREEK RD
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City | KILLEEN
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State | TX
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Zip | 76549-6093
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Country | US
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Telephone | 561-209-3565
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. MARCEL BOWENS SR.
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Credential |
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Telephone | 561-209-3565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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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 | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number |
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Taxonomy #3
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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Taxonomy #4
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Taxonomy Code | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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Taxonomy #5
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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Taxonomy #6
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Taxonomy Code | 251T00000X
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Taxonomy Name | PACE Provider Organization
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License Number |
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Taxonomy #7
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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