Provider Demographics
NPI:1518173616
Name:JT ASSOCIATES, INC
Entity Type:Organization
Organization Name:JT ASSOCIATES, INC
Other - Org Name:COMMUNITY CONNECTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:BATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-889-9695
Mailing Address - Street 1:406 MAYS BR
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-7810
Mailing Address - Country:US
Mailing Address - Phone:606-889-9695
Mailing Address - Fax:606-889-9695
Practice Address - Street 1:406 MAYS BR
Practice Address - Street 2:
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-7810
Practice Address - Country:US
Practice Address - Phone:606-874-1900
Practice Address - Fax:606-874-1902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY33000233Medicaid