Provider Demographics
NPI:1437623485
Name:JBC CONSOLIDATED, LLC
Entity Type:Organization
Organization Name:JBC CONSOLIDATED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:OBILO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-881-0312
Mailing Address - Street 1:4034 WHEAT HARVEST LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-6739
Mailing Address - Country:US
Mailing Address - Phone:832-881-0312
Mailing Address - Fax:832-913-6470
Practice Address - Street 1:4034 WHEAT HARVEST LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-6739
Practice Address - Country:US
Practice Address - Phone:832-881-0312
Practice Address - Fax:832-913-6470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-13
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities