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General NPI Number Information
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NPI Number | 1609642958
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Entity Type | Organization
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Legal Business Name | JENCARE COUNSELING AND COMMUNITY SERVICES LLC
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Dates
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Enumeration Date | 11/28/2023
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Last Update Date | 12/01/2023
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Provider Practice Location Address
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Address Line | 5957 W NORTHERN AVE STE 117
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City | GLENDALE
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State | AZ
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Zip | 85301-7825
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Country | US
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Telephone | 623-289-7140
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Fax |
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Provider Business Mailing Address
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Address Line | 7035 S 77TH LN
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City | LAVEEN
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State | AZ
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Zip | 85339-7232
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Country | US
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Telephone | 623-289-7140
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Fax |
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Authorized Official
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Title or Position | CEO/ADMINISTRATOR
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Name | JENNIFER LOFTERS
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Credential |
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Telephone | 602-696-2086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 276400000X
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Taxonomy Name | Substance Use Disorder Rehabilitation Hospital Unit
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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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 |
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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 |
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License Number State |
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