Provider Demographics
NPI:1821341207
Name:JHC IOP LLC
Entity Type:Organization
Organization Name:JHC IOP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSH
Authorized Official - Middle Name:
Authorized Official - Last Name:LANNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-840-2588
Mailing Address - Street 1:11624 E SHEA BLVD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259-5111
Mailing Address - Country:US
Mailing Address - Phone:480-840-2588
Mailing Address - Fax:480-767-2701
Practice Address - Street 1:11624 E SHEA BLVD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85259-5111
Practice Address - Country:US
Practice Address - Phone:480-840-2588
Practice Address - Fax:480-767-2701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-22
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH4054261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder