The Jeanie Jane Foundation

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

THE JEANIE JANE FOUNDATION

Practice address

4213 Woodward CT
Grand Prairie, TX 75052-3932

Phone

(682) 888-8417

NPI assigned

Feb 11, 2015

Organization subpart

No

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

Authorized official

Name

Joycelyn Bagby

Title

Director

Phone

(682) 888-8417

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1423612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423612800000",
    "number": "1174914212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4213 WOODWARD CT",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750523932",
            "telephone_number": "682-888-8417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4213 WOODWARD CT",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750523932",
            "telephone_number": "682-888-8417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE JEANIE JANE FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-11",
        "last_updated": "2015-02-11",
        "status": "A",
        "authorized_official_last_name": "BAGBY",
        "authorized_official_first_name": "JOYCELYN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "682-888-8417"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Illness Community Based Residential Treatment Facility in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Mental Illness Community Based Residential Treatment Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2015; 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.