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General NPI Number Information
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NPI Number | 1871392415
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Entity Type | Organization
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Legal Business Name | JASMINE NYREE HOME
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Dates
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Enumeration Date | 03/07/2025
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 3048 ASHLYN STREET
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City | PITTSBURGH
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State | PA
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Zip | 15204
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Country | US
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Telephone | 412-520-8401
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Fax | 412-520-8401
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Provider Business Mailing Address
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Address Line | 3011 LANDIS ST
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City | PITTSBURGH
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State | PA
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Zip | 15204-1713
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Country | US
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Telephone | 412-520-8401
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Fax | 412-520-8401
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Authorized Official
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Title or Position | DIRECTOR OF SUPPORTIVE SERVICES
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Name | MR. MARQUE RUDOLPH STANSBERRY
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Credential |
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Telephone | 412-520-8401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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Taxonomy #3
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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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Taxonomy #4
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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Taxonomy #5
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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Taxonomy #6
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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Taxonomy #7
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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Taxonomy #8
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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Taxonomy #9
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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