Provider Demographics
NPI:1790393197
Name:JOVEN HEALTH, LLC
Entity type:Organization
Organization Name:JOVEN HEALTH, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BUSINESS DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MCCORD
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:734-486-5579
Mailing Address - Street 1:3854 S HALIFAX ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-3973
Mailing Address - Country:US
Mailing Address - Phone:734-486-5579
Mailing Address - Fax:
Practice Address - Street 1:3635 E LARSON LN
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-7229
Practice Address - Country:US
Practice Address - Phone:734-486-5579
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOCIAL FABRIC, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-21
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty