MEDICARE: JUPRIES HAVEN LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1992544902
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JUPRIES HAVEN LLC

Provider Business Mailing Address
First Line	:	4088 BRACKENWOOD TRL
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43228-8437
Country	:	US
Telephone Number	:	614-390-0145
Fax Number	:

Provider Business Practice Location Address
First Line	:	4088 BRACKENWOOD TRL
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43228-8437
Country	:	US
Telephone Number	:	614-390-0145
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. JUDE AZHINUE NEBA
Credential	:	CEO
Telephone Number	:	614-390-0145

Provider Enumeration Date	:	05/20/2024
Last Update Date	:	05/20/2024

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Directions to “JUPRIES HAVEN LLC ” Practice Location

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