Provider Demographics
NPI:1386821650
Name:JBNC, INC.
Entity Type:Organization
Organization Name:JBNC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:A
Authorized Official - Middle Name:BRANDON
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-932-0050
Mailing Address - Street 1:5504 E JOHNSON AVE.
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-8309
Mailing Address - Country:US
Mailing Address - Phone:870-932-3271
Mailing Address - Fax:
Practice Address - Street 1:5504 E JOHNSON AVE.
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-8309
Practice Address - Country:US
Practice Address - Phone:870-932-3271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR855314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR166825311Medicaid
AR045327Medicare Oscar/Certification