Jireh's Place, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

JIREH'S PLACE, INC.

Practice address

5128 Rosemede Dr
Charlotte, NC 28227-3011

Phone

(704) 535-5590

NPI assigned

Feb 28, 2007

Last updated

Aug 22, 2020By 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

Mr. Edward Phillip Vandershorst

Title

Executive Director

Phone

(704) 535-5590

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750418273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5128 ROSEMEDE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282273011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5128 ROSEMEDE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282273011",
            "telephone_number": "704-535-5590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIREH'S PLACE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VANDERSHORST",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "PHILLIP",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "704-535-5590",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408050",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mays Janet Jimenez, LCSW-A
• Nneka T Jimoh, MD
• Olanrewaju Yusuf Jimoh, MD, MBA
• Jing Jin
• Jireh Homes LLC
• JK Communication Services
• JLS Carriers Nemt LLC
• JLW Medical Management Consulting, LLC
• JM Counseling & Support Services
• JMMR Healthcare Associates PLLC (Oui Care Home Health Concierge)

• Community/Behavioral Health Agency in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.