Provider Demographics
NPI:1093240012
Name:JELANI, INC
Entity Type:Organization
Organization Name:JELANI, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ADONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MIDDLETON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-822-3260
Mailing Address - Street 1:1601 QUESADA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94124-2334
Mailing Address - Country:US
Mailing Address - Phone:415-822-5977
Mailing Address - Fax:415-671-1042
Practice Address - Street 1:1601 QUESADA AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94124-2334
Practice Address - Country:US
Practice Address - Phone:415-822-5977
Practice Address - Fax:415-671-1042
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAYVIEW HUNTERS POINT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-04-27
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility