NPIMap

Organization Active NPI

Jakes Place for Change, LLC

  • Community/Behavioral Health Agency
  • Rainbow City, AL
National Provider Identifier
1104328012
Registry record updated Mar 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
JAKES PLACE FOR CHANGE, LLC
Practice address
116 Church St Ste 4
Rainbow City, AL 35906-6287
Phone
(256) 459-5600
NPI assigned
Mar 6, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2018

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

Authorized official

Name
Stephanie Lane, MS COUNSELING, LBSW
Title
Director/Owner
Phone
(256) 459-5600

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Local Education Agency (LEA) 251300000X
Case Management Agency 251B00000X
Public Health or Welfare Agency 251K00000X
Community/Behavioral Health Agency 251S00000X Primary
In Home Supportive Care Agency 253Z00000X
Clinic/Center 261Q00000X
Community Health Clinic/Center 261QC1500X
Developmental Disabilities Clinic/Center 261QD1600X
Non-Surgical Family Planning Clinic/Center 261QF0050X
Health Service Clinic/Center 261QH0100X
Adult Mental Health Clinic/Center 261QM0850X
Rehabilitation Clinic/Center 261QR0400X
Research Clinic/Center 261QR1100X
Private Vehicle 347C00000X
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X

Addresses

Primary practice location

116 Church St Ste 4
Rainbow City, AL 35906-6287

Mailing address

116 Church St Ste 4
Rainbow City, AL 35906-6287
Phone (256) 459-5600

National Provider Directory

National Provider Directory

Locations

116 Church St
Ste 4
Rainbow City, AL 35906
Phone (256) 459-5600

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1520294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520294400000",
    "number": "1104328012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 CHURCH ST STE 4",
            "city": "RAINBOW CITY",
            "state": "AL",
            "postal_code": "359066287",
            "telephone_number": "256-459-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 CHURCH ST STE 4",
            "city": "RAINBOW CITY",
            "state": "AL",
            "postal_code": "359066287",
            "telephone_number": "256-459-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAKES PLACE FOR CHANGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-06",
        "last_updated": "2018-03-06",
        "status": "A",
        "authorized_official_last_name": "LANE",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "256-459-5600",
        "authorized_official_credential": "MS COUNSELING, LBSW"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Family Planning, Non-Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Research",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rainbow City, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2018; 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.