Provider Demographics
NPI: | 1215425301 |
---|---|
Name: | JEDUCARE SERVICES, INC |
Entity type: | Organization |
Organization Name: | JEDUCARE SERVICES, INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | VALENTINE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | AKPUA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 202-560-8577 |
Mailing Address - Street 1: | 7183 OLD ALEXANDRIA FERRY RD |
Mailing Address - Street 2: | |
Mailing Address - City: | CLINTON |
Mailing Address - State: | MD |
Mailing Address - Zip Code: | 20735-1763 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 202-560-8577 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 7183 OLD ALEXANDRIA FERRY RD |
Practice Address - Street 2: | |
Practice Address - City: | CLINTON |
Practice Address - State: | MD |
Practice Address - Zip Code: | 20735-1763 |
Practice Address - Country: | US |
Practice Address - Phone: | 202-560-8577 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2018-04-25 |
Last Update Date: | 2018-04-25 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MD | 103K00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | Group - Single Specialty |