Provider Demographics
NPI:1861178857
Name:JB WELLNESS LLC
Entity type:Organization
Organization Name:JB WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LEAD THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JANAY
Authorized Official - Middle Name:
Authorized Official - Last Name:BANKSTON
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-S
Authorized Official - Phone:216-302-8983
Mailing Address - Street 1:PO BOX 25772
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44125-0772
Mailing Address - Country:US
Mailing Address - Phone:216-302-8983
Mailing Address - Fax:
Practice Address - Street 1:3030 EUCLID AVE STE 212B
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115-2518
Practice Address - Country:US
Practice Address - Phone:216-302-8983
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty