Provider Demographics
NPI:1356916621
Name:JIGSAW HEALTHCARE, LLC
Entity type:Organization
Organization Name:JIGSAW HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:BRANDISS
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:706-473-2601
Mailing Address - Street 1:106A N JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:EATONTON
Mailing Address - State:GA
Mailing Address - Zip Code:31024-1020
Mailing Address - Country:US
Mailing Address - Phone:706-473-2601
Mailing Address - Fax:877-275-1192
Practice Address - Street 1:106A N JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:EATONTON
Practice Address - State:GA
Practice Address - Zip Code:31024-1020
Practice Address - Country:US
Practice Address - Phone:706-473-2601
Practice Address - Fax:877-275-1192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty