Provider Demographics
NPI:1144495896
Name:JOB AND FAMILY SERVICES
Entity type:Organization
Organization Name:JOB AND FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN NURSE
Authorized Official - Prefix:
Authorized Official - First Name:CRISTI
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:GATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-501-2198
Mailing Address - Street 1:106 S ROGERS ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-3643
Mailing Address - Country:US
Mailing Address - Phone:740-501-2198
Mailing Address - Fax:
Practice Address - Street 1:106 S ROGERS ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-3643
Practice Address - Country:US
Practice Address - Phone:740-501-2198
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN-114978320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2725500Medicaid