Provider Demographics
NPI:1205293537
Name:JMB SERVICES INC
Entity type:Organization
Organization Name:JMB SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BRUSICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-425-2087
Mailing Address - Street 1:5121 SUMTER CIR
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-7804
Mailing Address - Country:US
Mailing Address - Phone:701-425-2087
Mailing Address - Fax:
Practice Address - Street 1:1911 N 11TH ST
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-1915
Practice Address - Country:US
Practice Address - Phone:701-258-1569
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-17
Last Update Date:2016-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities