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General NPI Number Information
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NPI Number | 1477471332
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Entity Type | Organization
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Legal Business Name | JBI WELLNESS, LLC
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Dates
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Enumeration Date | 07/08/2026
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Last Update Date | 07/08/2026
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Provider Practice Location Address
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Address Line | 2928 GAVIOTA CIR
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City | CARLSBAD
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State | CA
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Zip | 92009-8216
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Country | US
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Telephone | 516-650-9240
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Fax |
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Provider Business Mailing Address
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Address Line | 3142 VISTA WAY STE 207
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City | OCEANSIDE
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State | CA
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Zip | 92056-3628
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Country | US
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Telephone | 516-650-9240
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | JOSEPH HEAPHY
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Credential |
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Telephone | 516-650-9240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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