Provider Demographics
NPI:1629242722
Name:JUNIATA AGAPE MINISTRIES INC
Entity Type:Organization
Organization Name:JUNIATA AGAPE MINISTRIES INC
Other - Org Name:THE JAM HOUSE
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-436-2163
Mailing Address - Street 1:HC 67 BOX 6B
Mailing Address - Street 2:
Mailing Address - City:MIFFLIN
Mailing Address - State:PA
Mailing Address - Zip Code:17058-9700
Mailing Address - Country:US
Mailing Address - Phone:717-436-2163
Mailing Address - Fax:
Practice Address - Street 1:HC 67 BOX 6B
Practice Address - Street 2:ROUTE 35 SOUTH
Practice Address - City:MIFFLIN
Practice Address - State:PA
Practice Address - Zip Code:17058-9700
Practice Address - Country:US
Practice Address - Phone:717-436-2163
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-18
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities