Provider Demographics
NPI:1588856835
Name:JODI'S ENTERPRISES, INC.
Entity Type:Organization
Organization Name:JODI'S ENTERPRISES, INC.
Other - Org Name:REEVES ASSISTED LIVING DBA SOUTHERN HAVEN
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JODI
Authorized Official - Middle Name:ANITA
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-660-1324
Mailing Address - Street 1:279 HAIG MILL RD NW
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30721-7958
Mailing Address - Country:US
Mailing Address - Phone:404-660-1324
Mailing Address - Fax:706-226-9158
Practice Address - Street 1:279 HAIG MILL RD NW
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30721-7958
Practice Address - Country:US
Practice Address - Phone:404-660-1324
Practice Address - Fax:706-226-9158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care