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General NPI Number Information
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NPI Number | 1356882021
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Entity Type | Organization
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Legal Business Name | JUBILEE SERVICES, LLC
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Dates
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Enumeration Date | 03/15/2017
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Last Update Date | 03/15/2017
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Provider Practice Location Address
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Address Line | 165 ALFRED AVE
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City | RED SPRINGS
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State | NC
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Zip | 28377-7496
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Country | US
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Telephone | 910-227-3875
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Fax |
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Provider Business Mailing Address
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Address Line | 165 ALFRED AVE
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City | RED SPRINGS
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State | NC
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Zip | 28377-7496
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Country | US
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Telephone | 910-227-3875
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. LARRY QUICK
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Credential |
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Telephone | 910-227-3875
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number |
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License Number State | NC
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Taxonomy #3
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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 | NC
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