J-Lo Homes, LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

MHL-096-200 Issued in NC

Legal business name

J-LO HOMES, LLC

Practice address

208 Randall LN
Goldsboro, NC 27534-8837

Phone

(919) 221-6719

Fax

(919) 734-4950

NPI assigned

Jul 11, 2007

Last updated

Jul 11, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Miss Dana Elaine Williams, B.A.

Title

Executive Director

Phone

(919) 222-2407

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184112000000",
    "number": "1033318969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S PINEVIEW AVE",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275306039",
            "telephone_number": "919-734-3924",
            "fax_number": "919-734-4950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 RANDALL LN",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275348837",
            "telephone_number": "919-221-6719",
            "fax_number": "919-734-4950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J-LO HOMES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-11",
        "last_updated": "2007-07-11",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "919-222-2407",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "B.A."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "MHL-096-200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Briggs Inyang, MD
• Dennis A Isenhower, PA-C
• Sabrine A. Ishimwe
• Marina Iskander
• Paula Hill Ivey, FNP-C
• Jose Francisco Jacinto-Martin
• Bliss Jackson
• Brittany Oliver Jackson, FNP
• Duncan Lea Jackson
• Micaiah Jackson, DPT

• Mental Illness Community Based Residential Treatment Facility in Goldsboro, NC
• Providers in Goldsboro, NC by specialty
• Mental Illness Community Based Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.