Provider Demographics
NPI:1194028290
Name:JUSTICE RESOURCE INSTITUTE
Entity Type:Organization
Organization Name:JUSTICE RESOURCE INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:MIGEUL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-320-6185
Mailing Address - Street 1:889 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02632-3067
Mailing Address - Country:US
Mailing Address - Phone:508-771-2402
Mailing Address - Fax:
Practice Address - Street 1:889 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02632-3067
Practice Address - Country:US
Practice Address - Phone:508-771-2402
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-10
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health