Provider Demographics
NPI:1710501127
Name:JCO GROUP OF SERVICES
Entity Type:Organization
Organization Name:JCO GROUP OF SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:DAMION
Authorized Official - Middle Name:
Authorized Official - Last Name:OUTAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:857-269-8737
Mailing Address - Street 1:128 NEWBURY AVE
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02171-2238
Mailing Address - Country:US
Mailing Address - Phone:857-269-8737
Mailing Address - Fax:
Practice Address - Street 1:31 DOVER ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-5938
Practice Address - Country:US
Practice Address - Phone:857-269-8737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-01
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health