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General NPI Number Information
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NPI Number | 1679246920
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Entity Type | Organization
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Legal Business Name | J AND M MENTORING
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Dates
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Enumeration Date | 07/30/2021
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Last Update Date | 07/30/2021
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Provider Practice Location Address
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Address Line | 3347 ERVIN RD NW APT C
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City | DOVER
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State | OH
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Zip | 44622-7807
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Country | US
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Telephone | 330-934-7659
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 386
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City | UHRICHSVILLE
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State | OH
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Zip | 44683-0386
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Country | US
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Telephone | 330-934-7659
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MELISSA ALLEN
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Credential |
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Telephone | 330-934-7659
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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