Provider Demographics
NPI:1902281546
Name:JAYLARAY CAREGIVING PLACE, LLC.
Entity Type:Organization
Organization Name:JAYLARAY CAREGIVING PLACE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QBA
Authorized Official - Prefix:MRS
Authorized Official - First Name:APE
Authorized Official - Middle Name:J
Authorized Official - Last Name:SULUNGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-360-5363
Mailing Address - Street 1:1285 CROWN DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-2205
Mailing Address - Country:US
Mailing Address - Phone:775-354-3991
Mailing Address - Fax:
Practice Address - Street 1:1285 CROWN DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-2205
Practice Address - Country:US
Practice Address - Phone:775-354-3991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-24
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty