Provider Demographics
NPI:1659124097
Name:JONES-NEELY, LORACHA SADE
Entity Type:Individual
Prefix:
First Name:LORACHA
Middle Name:SADE
Last Name:JONES-NEELY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 E UNION ST
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48502-2036
Mailing Address - Country:US
Mailing Address - Phone:810-760-7300
Mailing Address - Fax:
Practice Address - Street 1:2001 N CENTER RD APT 110
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48506-3198
Practice Address - Country:US
Practice Address - Phone:810-308-4094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider