Provider Demographics
NPI:1497071948
Name:JP, INC
Entity Type:Organization
Organization Name:JP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KEISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-209-7788
Mailing Address - Street 1:2917 BURROUGHS DR APT 7
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-2746
Mailing Address - Country:US
Mailing Address - Phone:407-209-7788
Mailing Address - Fax:407-412-6857
Practice Address - Street 1:2917 BURROUGHS DRIVE #7
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-5614
Practice Address - Country:US
Practice Address - Phone:407-209-7788
Practice Address - Fax:407-412-6857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-08
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006623601Medicaid