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General NPI Number Information
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NPI Number | 1700023884
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Entity Type | Organization
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Legal Business Name | JOFFY INTERNATIONAL INC
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Dates
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Enumeration Date | 01/12/2009
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Last Update Date | 01/12/2009
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Provider Practice Location Address
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Address Line | 401 MISTY LN
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City | LEWISVILLE
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State | TX
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Zip | 75067-6253
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Country | US
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Telephone | 214-517-5058
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Fax | 214-222-3103
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Provider Business Mailing Address
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Address Line | 401 MISTY LN
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City | LEWISVILLE
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State | TX
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Zip | 75067-6253
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Country | US
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Telephone | 214-517-5058
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. OSAYAWE AGBONTAEN
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Credential |
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Telephone | 214-517-5058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310500000X
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Taxonomy Name | Mental Illness Intermediate Care Facility
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License Number |
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License Number State |
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