Provider Demographics
NPI:1518493394
Name:JAY HASH LLC
Entity Type:Organization
Organization Name:JAY HASH LLC
Other - Org Name:HOPESOURCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:LAWLER
Authorized Official - Last Name:HASH
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC-S LICDC-CS
Authorized Official - Phone:740-727-1520
Mailing Address - Street 1:800 GALLIA ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-4035
Mailing Address - Country:US
Mailing Address - Phone:740-353-4673
Mailing Address - Fax:740-353-5800
Practice Address - Street 1:800 GALLIA ST
Practice Address - Street 2:SUITE 600
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-4035
Practice Address - Country:US
Practice Address - Phone:740-353-4673
Practice Address - Fax:740-353-5800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH01-7576251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0144728Medicaid