Provider Demographics
NPI:1326619263
Name:HILL, JAMARR
Entity Type:Individual
Prefix:
First Name:JAMARR
Middle Name:
Last Name:HILL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1783 E NORTH BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-4365
Mailing Address - Country:US
Mailing Address - Phone:614-704-6112
Mailing Address - Fax:
Practice Address - Street 1:1783 E NORTH BROADWAY ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-4365
Practice Address - Country:US
Practice Address - Phone:614-704-6112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-01
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
OH385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No251S00000XAgenciesCommunity/Behavioral Health