Provider Demographics
NPI:1851958847
Name:JIREH HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:JIREH HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAULINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGNY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-441-0325
Mailing Address - Street 1:5780 HEMING AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22151-2715
Mailing Address - Country:US
Mailing Address - Phone:202-441-0325
Mailing Address - Fax:
Practice Address - Street 1:5780 HEMING AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22151-2715
Practice Address - Country:US
Practice Address - Phone:202-441-0325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-24
Last Update Date:2019-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities