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General NPI Number Information
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NPI Number | 1619481793
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Entity Type | Organization
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Legal Business Name | JNR CARE, LLC
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Dates
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Enumeration Date | 11/28/2017
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 127 BROYLES DR SE
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City | PALM BAY
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State | FL
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Zip | 32909-2350
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Country | US
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Telephone | 321-307-5415
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Fax | 321-244-0222
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Provider Business Mailing Address
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Address Line | 127 BROYLES DR SE
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City | PALM BAY
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State | FL
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Zip | 32909-2350
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Country | US
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Telephone | 321-266-5166
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JHOANE LALEAU
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Credential |
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Telephone | 321-266-5166
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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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