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General NPI Number Information
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NPI Number | 1356881551
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Entity Type | Organization
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Legal Business Name | JAY'S HOUSE, INC
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Dates
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Enumeration Date | 03/07/2017
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Last Update Date | 03/07/2017
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Provider Practice Location Address
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Address Line | 25 N PENNEWELL DR
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City | WILMINGTON
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State | DE
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Zip | 19809-3313
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Country | US
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Telephone | 302-544-2333
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Fax |
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Provider Business Mailing Address
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Address Line | 25 N PENNEWELL DR
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City | WILMINGTON
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State | DE
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Zip | 19809-3313
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Country | US
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Telephone | 302-544-2333
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ADA MONET CUNNINGHAN
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Credential |
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Telephone | 302-544-2333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | DE
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