Provider Demographics
NPI:1033957014
Name:JAYBROOK FOUNDATION
Entity type:Organization
Organization Name:JAYBROOK FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MOHR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-804-9374
Mailing Address - Street 1:1718 TIMBER HILLS DR
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-3014
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1718 TIMBER HILLS DR
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-3014
Practice Address - Country:US
Practice Address - Phone:319-804-9374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-16
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No177F00000XOther Service ProvidersLodging
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No251V00000XAgenciesVoluntary or Charitable
No251X00000XAgenciesSupports Brokerage
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No305R00000XManaged Care OrganizationsPreferred Provider Organization
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care