Provider Demographics
NPI:1215775846
Name:JACOB'S HOPE, INC.
Entity type:Organization
Organization Name:JACOB'S HOPE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JO
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-618-6620
Mailing Address - Street 1:1150 N COUNTRY CLUB DR # 12A
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85201-2537
Mailing Address - Country:US
Mailing Address - Phone:602-618-6620
Mailing Address - Fax:
Practice Address - Street 1:1150 N COUNTRY CLUB DR # 12A
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-2537
Practice Address - Country:US
Practice Address - Phone:602-618-6620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)