Provider Demographics
NPI:1013540731
Name:JFHS LLC
Entity Type:Organization
Organization Name:JFHS LLC
Other - Org Name:JACKSON FAMILY HUMAN SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:442-327-9172
Mailing Address - Street 1:15490 CIVIC DR STE 103
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92392-2382
Mailing Address - Country:US
Mailing Address - Phone:442-327-9172
Mailing Address - Fax:442-327-9173
Practice Address - Street 1:18522 US HIGHWAY 18 STE 207
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-2321
Practice Address - Country:US
Practice Address - Phone:442-327-9172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-20
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Single Specialty