Provider Demographics
NPI:1538727870
Name:JA HEALTHCARE SERVICES, LLC
Entity type:Organization
Organization Name:JA HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:IJIWOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-257-3917
Mailing Address - Street 1:113 WEST RD STE 202A
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2300
Mailing Address - Country:US
Mailing Address - Phone:410-337-2697
Mailing Address - Fax:410-321-0580
Practice Address - Street 1:113 WEST RD STE 202A
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2300
Practice Address - Country:US
Practice Address - Phone:410-337-3697
Practice Address - Fax:410-321-0580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-02
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty