Provider Demographics
NPI:1508916677
Name:MONTGOMERY COUNTY JUVENILE DRUG COURT
Entity Type:Organization
Organization Name:MONTGOMERY COUNTY JUVENILE DRUG COURT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-496-6838
Mailing Address - Street 1:3501 MERRIMAC AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45405-2646
Mailing Address - Country:US
Mailing Address - Phone:937-496-6838
Mailing Address - Fax:937-496-7779
Practice Address - Street 1:3501 MERRIMAC AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405-2646
Practice Address - Country:US
Practice Address - Phone:937-496-6838
Practice Address - Fax:937-496-7779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management