Provider Demographics
NPI:1659412021
Name:JACOBY INC.
Entity Type:Organization
Organization Name:JACOBY INC.
Other - Org Name:LEONARD JACOBY, L.AC
Other - Org Type:Other Name
Authorized Official - Title/Position:PREESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBY
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:808-662-4808
Mailing Address - Street 1:PO BOX13190
Mailing Address - Street 2:
Mailing Address - City:LAHAINA
Mailing Address - State:HI
Mailing Address - Zip Code:96761
Mailing Address - Country:US
Mailing Address - Phone:808-662-4808
Mailing Address - Fax:808-662-4809
Practice Address - Street 1:930 WAINEE STREET
Practice Address - Street 2:SUITE 10
Practice Address - City:LAHAINA
Practice Address - State:HI
Practice Address - Zip Code:96761
Practice Address - Country:US
Practice Address - Phone:808-662-4808
Practice Address - Fax:808-662-4809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIACU-450171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty