Provider Demographics
NPI:1689993388
Name:JONES SPECIALTY HEALTHCARE LLC
Entity Type:Organization
Organization Name:JONES SPECIALTY HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LISCENSED SOCIAL WORKER (PRESIDENT)
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:JONES
Authorized Official - Suffix:JR
Authorized Official - Credentials:LSW
Authorized Official - Phone:330-307-9970
Mailing Address - Street 1:1537 WESTWOOD DR NW
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44485-1837
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1537 WESTWOOD DR NW
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44485-1837
Practice Address - Country:US
Practice Address - Phone:330-307-9970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-20
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.0700233251B00000X
OHSP-2496251E00000X
OHS.0001909251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health