Provider Demographics
NPI:1760531909
Name:JONES'S EXTENDED FAMILY SERVICES
Entity Type:Organization
Organization Name:JONES'S EXTENDED FAMILY SERVICES
Other - Org Name:ST. LUKE CHURCH ROAD GROUP HOME
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:TORONA
Authorized Official - Middle Name:L
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-479-6281
Mailing Address - Street 1:8 WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27292-2361
Mailing Address - Country:US
Mailing Address - Phone:336-236-1846
Mailing Address - Fax:336-236-2450
Practice Address - Street 1:1714 SAINT LUKE CHURCH RD
Practice Address - Street 2:
Practice Address - City:GOLDSTON
Practice Address - State:NC
Practice Address - Zip Code:27252-9562
Practice Address - Country:US
Practice Address - Phone:919-898-4600
Practice Address - Fax:919-898-4600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-019-037320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness