Provider Demographics
NPI:1609534544
Name:ST JAMES HOMES LLC
Entity Type:Organization
Organization Name:ST JAMES HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:BERINYUY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-264-9976
Mailing Address - Street 1:1636 NW 32ND LN UNIT 22
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-0002
Mailing Address - Country:US
Mailing Address - Phone:240-264-9976
Mailing Address - Fax:
Practice Address - Street 1:1636 NW 32ND LN UNIT 22
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-0002
Practice Address - Country:US
Practice Address - Phone:240-264-9976
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-07
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health