Provider Demographics
NPI:1225908007
Name:JM FAMILY CARE SERVICES, LLC
Entity type:Organization
Organization Name:JM FAMILY CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMIL
Authorized Official - Middle Name:DOMINIQUE
Authorized Official - Last Name:MORAVIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-493-8020
Mailing Address - Street 1:2515 PHILLIPS AVE STE A
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-5357
Mailing Address - Country:US
Mailing Address - Phone:336-542-0581
Mailing Address - Fax:336-542-0464
Practice Address - Street 1:2515 PHILLIPS AVE STE A
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-5357
Practice Address - Country:US
Practice Address - Phone:336-542-0581
Practice Address - Fax:336-542-0464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-07
Last Update Date:2025-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health