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General NPI Number Information
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NPI Number | 1861761629
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Entity Type | Organization
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Legal Business Name | THE JAN GROUP LLC
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Dates
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Enumeration Date | 12/23/2011
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Last Update Date | 12/23/2011
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Provider Practice Location Address
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Address Line | 2336 N 25TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19132-4204
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Country | US
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Telephone | 215-227-0296
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 50420
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City | PHILADELPHIA
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State | PA
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Zip | 19132-6420
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DEBORAH CROWLEY
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Credential |
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Telephone | 267-250-4777
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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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