Provider Demographics
NPI:1669508230
Name:J PETER INC
Entity Type:Organization
Organization Name:J PETER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JAMERIALA
Authorized Official - Middle Name:NMN
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-848-4288
Mailing Address - Street 1:7722 KINGSBERRY CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-5039
Mailing Address - Country:US
Mailing Address - Phone:919-848-2282
Mailing Address - Fax:
Practice Address - Street 1:7722 KINGSBERRY CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-5039
Practice Address - Country:US
Practice Address - Phone:919-848-2282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8301356Medicaid
NC8301144Medicaid