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General NPI Number Information
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NPI Number | 1487422762
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Entity Type | Organization
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Legal Business Name | JEWELS OF PURPOSE SUPPORTED LIVING
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Dates
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Enumeration Date | 12/15/2023
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Last Update Date | 12/15/2023
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Provider Practice Location Address
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Address Line | 1131 FAIRWAY BLVD
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City | WHITEHALL
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State | OH
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Zip | 43213-2522
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Country | US
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Telephone | 614-390-9716
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Fax |
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Provider Business Mailing Address
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Address Line | 1131 FAIRWAY BLVD
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City | WHITEHALL
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State | OH
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Zip | 43213-2522
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Country | US
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Telephone | 614-390-9716
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. YOLANDA ADAMS
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Credential |
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Telephone | 614-390-9716
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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