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General NPI Number Information
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NPI Number | 1932310364
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Entity Type | Organization
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Legal Business Name | J&J RESIDENTIAL SERVICES INC.
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 52 GREENE ST
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City | SMITHFIELD
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State | OH
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Zip | 43948
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Country | US
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Telephone | 740-733-7095
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Fax |
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Provider Business Mailing Address
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Address Line | 37 GREENE STR. P.O. BOX 50
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City | SMITHFIELD
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State | OH
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Zip | 43948
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Country | US
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Telephone | 740-733-7095
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DONALD ANDERSON CLINE JR.
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Credential | OWNER
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Telephone | 740-733-7095
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0005X
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Taxonomy Name | Ambulatory Family Planning Facility
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License Number | 4100574
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License Number State | OH
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