Provider Demographics
NPI:1356091649
Name:TEAM JESUS MOST HOPE LLC
Entity Type:Organization
Organization Name:TEAM JESUS MOST HOPE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KESHIA
Authorized Official - Middle Name:N
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:513-795-6972
Mailing Address - Street 1:3515 SIARON WAY
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-2684
Mailing Address - Country:US
Mailing Address - Phone:513-795-6972
Mailing Address - Fax:513-795-6978
Practice Address - Street 1:3515 SIARON WAY
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-2684
Practice Address - Country:US
Practice Address - Phone:513-795-6972
Practice Address - Fax:513-795-6978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty