Provider Demographics
NPI:1275808990
Name:JEST GROUP HOMES INC
Entity Type:Organization
Organization Name:JEST GROUP HOMES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:QUENZELL
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-690-3371
Mailing Address - Street 1:4802 ABERDEEN RD
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-7854
Mailing Address - Country:US
Mailing Address - Phone:910-690-3371
Mailing Address - Fax:910-944-0551
Practice Address - Street 1:4802 ABERDEEN RD
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-7854
Practice Address - Country:US
Practice Address - Phone:910-690-3371
Practice Address - Fax:910-944-0551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No251B00000XAgenciesCase Management