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General NPI Number Information
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NPI Number | 1205382918
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Entity Type | Organization
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Legal Business Name | JAFA GROUP, INC.
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | 110 W RANDOL MILL RD
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City | ARLINGTON
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State | TX
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Zip | 76011-4611
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Country | US
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Telephone | 817-721-8074
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Fax | 817-277-1144
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Provider Business Mailing Address
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Address Line | 1441 PALMNILD CIRCLE WEST
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City | FORT WORTH
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State | TX
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Zip | 76120-4707
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Country | US
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Telephone | 817-721-8074
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Fax | 817-277-1144
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Authorized Official
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Title or Position | THERAPIST
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Name | MR. JAMES A FARMER
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Credential | PH.D.
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Telephone | 817-721-8074
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 24433
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License Number State | TX
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