Provider Demographics
NPI:1497254122
Name:J.A.H. ENTERPRISES, LLC
Entity Type:Organization
Organization Name:J.A.H. ENTERPRISES, LLC
Other - Org Name:DR. JAN H. HENRIQUES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JAN
Authorized Official - Middle Name:H
Authorized Official - Last Name:HENRIQUES
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:770-235-8283
Mailing Address - Street 1:12195 HWY. 92
Mailing Address - Street 2:SUITE 114-325
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188
Mailing Address - Country:US
Mailing Address - Phone:770-235-8283
Mailing Address - Fax:770-200-1544
Practice Address - Street 1:12195 HWY. 92
Practice Address - Street 2:SUITE 114-325
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188
Practice Address - Country:US
Practice Address - Phone:770-235-8283
Practice Address - Fax:770-200-1544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-08
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty