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General NPI Number Information
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NPI Number | 1780960708
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Entity Type | Organization
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Legal Business Name | GAIL JONES
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Dates
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Enumeration Date | 10/24/2011
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Last Update Date | 10/24/2011
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Provider Practice Location Address
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Address Line | 2766 GRAND HAVEN DR
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City | REYNOLDSBURG
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State | OH
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Zip | 43068-5200
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Country | US
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Telephone | 614-517-3440
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Fax |
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Provider Business Mailing Address
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Address Line | 2766 GRAND HAVEN DR
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City | REYNOLDSBURG
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State | OH
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Zip | 43068-5200
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Country | US
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Telephone | 614-517-3440
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Fax |
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Authorized Official
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Title or Position | LPN
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Name | MISS GAIL MARIE JONES
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Credential |
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Telephone | 614-517-3440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number | PN091537
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License Number State | OH
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