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General NPI Number Information
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NPI Number | 1669186185
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Entity Type | Organization
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Legal Business Name | JNA HOMES OF HOPE LLC
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Dates
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Enumeration Date | 01/09/2023
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Last Update Date | 01/24/2023
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Provider Practice Location Address
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Address Line | 1531 W MALDONADO RD
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City | PHOENIX
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State | AZ
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Zip | 85041-6642
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Country | US
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Telephone | 682-294-9632
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Fax |
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Provider Business Mailing Address
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Address Line | 1531 W MALDONADO RD
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City | PHOENIX
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State | AZ
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Zip | 85041-6642
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Country | US
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Telephone | 682-294-9632
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | ANGELICA TIBECA MATTHEWS
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Credential |
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Telephone | 682-294-9632
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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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