Provider Demographics
NPI:1164024113
Name:JV THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:JV THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JASMINE
Authorized Official - Middle Name:
Authorized Official - Last Name:RANDLE-MAYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-557-2728
Mailing Address - Street 1:8332 BROOKHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-8580
Mailing Address - Country:US
Mailing Address - Phone:815-557-2728
Mailing Address - Fax:
Practice Address - Street 1:8332 BROOKHAVEN DR
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-8580
Practice Address - Country:US
Practice Address - Phone:815-557-2728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No252Y00000XAgenciesEarly Intervention Provider Agency