Provider Demographics
NPI:1740801216
Name:JUBILEE COMMUNITY DEVELOPMENT CORPORATION
Entity Type:Organization
Organization Name:JUBILEE COMMUNITY DEVELOPMENT CORPORATION
Other - Org Name:JCDC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:SHIPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DD
Authorized Official - Phone:240-461-8096
Mailing Address - Street 1:3398 OAKHAM MOUNT DR
Mailing Address - Street 2:
Mailing Address - City:TRIANGLE
Mailing Address - State:VA
Mailing Address - Zip Code:22172-2342
Mailing Address - Country:US
Mailing Address - Phone:877-360-1177
Mailing Address - Fax:
Practice Address - Street 1:3398 OAKHAM MOUNT DR
Practice Address - Street 2:
Practice Address - City:TRIANGLE
Practice Address - State:VA
Practice Address - Zip Code:22172-2342
Practice Address - Country:US
Practice Address - Phone:877-360-1177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-06
Last Update Date:2020-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No251B00000XAgenciesCase Management
No252Y00000XAgenciesEarly Intervention Provider Agency