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General NPI Number Information
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NPI Number | 1376799585
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Entity Type | Organization
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Legal Business Name | JMJ ENTERPRISES
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Dates
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Enumeration Date | 08/07/2008
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Last Update Date | 05/03/2022
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Provider Practice Location Address
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Address Line | 2020 TEXTILE DR
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City | GREENSBORO
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State | NC
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Zip | 27405-5857
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Country | US
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Telephone | 336-271-6982
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Fax | 336-419-0456
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Provider Business Mailing Address
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Address Line | 2020 TEXTILE DR
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City | GREENSBORO
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State | NC
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Zip | 27405-5857
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Country | US
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Telephone | 336-988-1552
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Fax | 336-272-6604
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Authorized Official
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Title or Position | OWNER
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Name | MS. TRACI JOHNSON MARTIN
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Credential |
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Telephone | 336-375-3901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | MHL-041-1095
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | MHL-041-1115
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | MHL041857
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | MHL-041-1115
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License Number State | NC
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Taxonomy #5
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MHL-041-1115
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License Number State | NC
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Taxonomy #6
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MHL-041-1095
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License Number State | NC
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Taxonomy #7
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | MHL0411095
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License Number State | NC
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Taxonomy #8
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | MHL-041-1115
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License Number State | NC
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Taxonomy #9
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | MHL-041-1095
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License Number State | NC
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Taxonomy #12
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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