Provider Demographics
NPI:1164093407
Name:JAX SERVICES, LLC
Entity Type:Organization
Organization Name:JAX SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BETSY
Authorized Official - Middle Name:
Authorized Official - Last Name:WEEMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-749-2763
Mailing Address - Street 1:2700 E LIMEPIT RD
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:IN
Mailing Address - Zip Code:47952-8030
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2700 E LIMEPIT RD
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:IN
Practice Address - Zip Code:47952-8030
Practice Address - Country:US
Practice Address - Phone:765-749-2763
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty