Provider Demographics
NPI:1659080497
Name:J-MET HEALTH SERVICE LLC
Entity Type:Organization
Organization Name:J-MET HEALTH SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:POLLYN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-343-8450
Mailing Address - Street 1:7852 E BILLINGS ST
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85207-7548
Mailing Address - Country:US
Mailing Address - Phone:480-343-8450
Mailing Address - Fax:
Practice Address - Street 1:3065 S CANFIELD CIRCLE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85212
Practice Address - Country:US
Practice Address - Phone:480-343-8450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness