Provider Demographics
NPI:1205453602
Name:JBISHOP, LLC
Entity type:Organization
Organization Name:JBISHOP, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:MA, BCBA
Authorized Official - Phone:828-283-0620
Mailing Address - Street 1:200 N VINEYARD BLVD
Mailing Address - Street 2:STE A325-5146
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-0681
Mailing Address - Country:US
Mailing Address - Phone:828-283-0620
Mailing Address - Fax:808-748-0945
Practice Address - Street 1:200 N VINEYARD BLVD
Practice Address - Street 2:STE A325-5146
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-0681
Practice Address - Country:US
Practice Address - Phone:828-283-0620
Practice Address - Fax:808-748-0945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-01
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty