Provider Demographics
NPI:1902242084
Name:CHN JMH VENTURES LLC
Entity Type:Organization
Organization Name:CHN JMH VENTURES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AMBULATORY SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:E
Authorized Official - Last Name:FOHRER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-621-7432
Mailing Address - Street 1:7330 SHADELAND STATION
Mailing Address - Street 2:SUITE 200
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-3985
Mailing Address - Country:US
Mailing Address - Phone:317-621-7432
Mailing Address - Fax:317-621-7422
Practice Address - Street 1:3000 S STATE ROAD 135 STE 110
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-9829
Practice Address - Country:US
Practice Address - Phone:317-621-7432
Practice Address - Fax:317-621-7422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-16
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201192010AMedicaid