Provider Demographics
NPI:1639619950
Name:JUMP FOR JOY THERAPY SERVICES INC
Entity Type:Organization
Organization Name:JUMP FOR JOY THERAPY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:VILLARREAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-639-5018
Mailing Address - Street 1:1122 PORT ROYAL RD
Mailing Address - Street 2:
Mailing Address - City:PINGREE GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60140-9196
Mailing Address - Country:US
Mailing Address - Phone:224-639-5018
Mailing Address - Fax:888-759-8569
Practice Address - Street 1:1122 PORT ROYAL RD
Practice Address - Street 2:
Practice Address - City:PINGREE GROVE
Practice Address - State:IL
Practice Address - Zip Code:60140-9196
Practice Address - Country:US
Practice Address - Phone:224-639-5018
Practice Address - Fax:888-759-8569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-06
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency