Provider Demographics
NPI:1033736582
Name:JOMARV INC
Entity Type:Organization
Organization Name:JOMARV INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VICKY
Authorized Official - Middle Name:O
Authorized Official - Last Name:MICHAELS
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:972-699-7702
Mailing Address - Street 1:326 E 12TH ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75203-2606
Mailing Address - Country:US
Mailing Address - Phone:972-699-7702
Mailing Address - Fax:214-452-9938
Practice Address - Street 1:326 E 12TH ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75203-2606
Practice Address - Country:US
Practice Address - Phone:972-699-7702
Practice Address - Fax:214-452-9938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-01
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health