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General NPI Number Information
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NPI Number | 1972417095
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Entity Type | Organization
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Legal Business Name | JIREH HOMES LLC
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Dates
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Enumeration Date | 09/29/2026
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Last Update Date | 09/29/2026
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Provider Practice Location Address
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Address Line | 1126 MARIA CHRISTINA LN
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City | CHARLOTTE
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State | NC
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Zip | 28214-2349
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Country | US
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Telephone | 763-337-9473
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Fax |
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Provider Business Mailing Address
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Address Line | 1126 MARIA CHRISTINA LN
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City | CHARLOTTE
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State | NC
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Zip | 28214-2349
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Country | US
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Telephone | 763-337-9473
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Fax |
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Authorized Official
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Title or Position | CONSULTANT
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Name | CHANCE TYLER THOMPKINS
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Credential |
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Telephone | 980-228-8027
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State | NULL
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